Awaken Licensed Applied Behavioral Analysis Services Pllc | |
8480 Baltimore National Pike Ste 3210 #126 Ellicott City MD 21043 | |
(914) 713-7974 | |
Not Available |
Full Name | Awaken Licensed Applied Behavioral Analysis Services Pllc |
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Speciality | Behavior Analyst |
Location | 8480 Baltimore National Pike Ste 3210 #126, Ellicott City, Maryland |
Authorized Official Name and Position | Petagaye S. Townsend (CHIEF OPERATING OFFICER) |
Authorized Official Contact | 9143638313 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Awaken Licensed Applied Behavioral Analysis Services Pllc 8480 Baltimore National Pike Ste 3210 #126 Ellicott City MD 21043 Ph: (914) 713-7974 | Awaken Licensed Applied Behavioral Analysis Services Pllc 8480 Baltimore National Pike Ste 3210 #126 Ellicott City MD 21043 Ph: (914) 713-7974 |
NPI Number | 1174097547 |
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Provider Enumeration Date | 01/18/2019 |
Last Update Date | 04/30/2021 |
Certification Date | 04/30/2021 |
Identifier | Type | State | Issuer |
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1174097547 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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