| Magnolia Autism Group, Llc | |
|
822 Guilford Ave # 1555 Baltimore MD 21202-3707 | |
| (510) 457-1492 | |
| Not Available |
| Full Name | Magnolia Autism Group, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 822 Guilford Ave # 1555, Baltimore, Maryland |
| Authorized Official Name and Position | Emma Kostur (DIRECTOR) |
| Authorized Official Contact | 5104571492 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Autism Group, Llc 440 N Barranca Ave # 9605 Covina CA 91723-1722 Ph: () - | Magnolia Autism Group, Llc 822 Guilford Ave # 1555 Baltimore MD 21202-3707 Ph: (510) 457-1492 |
| NPI Number | 1811753874 |
|---|---|
| Provider Enumeration Date | 02/26/2024 |
| Last Update Date | 06/25/2024 |
| Certification Date | 06/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811753874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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