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7491 Old Alexandria Ferry Rd Clinton MD 20735-1834 | |
| (240) 244-9778 | |
| (240) 269-7799 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 7491 Old Alexandria Ferry Rd, Clinton, Maryland |
| Authorized Official Name and Position | Tiffany Dicks (OWNER) |
| Authorized Official Contact | 2402449778 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9722 Green Apple Turn Upper Marlboro MD 20772-4423 Ph: (240) 244-9778 | 7491 Old Alexandria Ferry Rd Clinton MD 20735-1834 Ph: (240) 244-9778 |
| NPI Number | 1386235323 |
|---|---|
| Provider Enumeration Date | 02/02/2021 |
| Last Update Date | 10/22/2024 |
| Certification Date | 10/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386235323 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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