| Blue Gems Aba Md Llc | |
|
10440 Little Patuxent Pkwy Ste 300 Columbia MD 21044-3648 | |
| (443) 656-9050 | |
| Not Available |
| Full Name | Blue Gems Aba Md Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 10440 Little Patuxent Pkwy Ste 300, Columbia, Maryland |
| Authorized Official Name and Position | David Wolf (CEO) |
| Authorized Official Contact | 6172977998 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Gems Aba Md Llc 101 Eisenhower Pkwy Roseland NJ 07068-1032 Ph: (617) 297-7998 | Blue Gems Aba Md Llc 10440 Little Patuxent Pkwy Ste 300 Columbia MD 21044-3648 Ph: (443) 656-9050 |
| NPI Number | 1285206037 |
|---|---|
| Provider Enumeration Date | 07/12/2021 |
| Last Update Date | 07/18/2024 |
| Certification Date | 07/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285206037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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