| Brain & Behavior Care Llc | |
|
3290 N Ridge Rd Ste 260 Ellicott City MD 21043-3655 | |
| (410) 988-2192 | |
| Not Available |
| Full Name | Brain & Behavior Care Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 3290 N Ridge Rd Ste 260, Ellicott City, Maryland |
| Authorized Official Name and Position | Si Si Han (OWNER) |
| Authorized Official Contact | 4109882192 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brain & Behavior Care Llc 3290 N Ridge Rd Ste 260 Ellicott City MD 21043-3655 Ph: (410) 988-2192 | Brain & Behavior Care Llc 3290 N Ridge Rd Ste 260 Ellicott City MD 21043-3655 Ph: (410) 988-2192 |
| NPI Number | 1780376731 |
|---|---|
| Provider Enumeration Date | 05/25/2023 |
| Last Update Date | 09/01/2023 |
| Certification Date | 09/01/2023 |
| Medicare PECOS PAC ID | 5698134260 |
|---|---|
| Medicare Enrollment ID | O20230630000043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780376731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | Si Si Han |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104305218 PECOS PAC ID: 5799102869 Enrollment ID: I20230630000062 |
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