MEDICARE: ALLY BEHAVIOR LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist
2	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1184429565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLY BEHAVIOR LLC

Provider Business Mailing Address
First Line	:	1410 SPRING HILL RD STE 305
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-3020
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5020 CAMPBELL BLVD STE I
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21236-4968
Country	:	US
Telephone Number	:	240-342-2666
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS ANALYST
Name	:	JOEY YOON
Credential	:
Telephone Number	:	301-450-4086

Provider Enumeration Date	:	02/18/2025
Last Update Date	:	02/18/2025

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Directions to “ALLY BEHAVIOR LLC ” Practice Location

Language	Start Address	Practice Location

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