MEDICARE: ARI DINSMOOR BCBA, MA

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1235736521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARI DINSMOOR BCBA, MA

Provider Business Mailing Address
First Line	:	1150 RIPLEY ST APT 1308
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-7431
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 RIPLEY ST APT 1308
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-7431
Country	:	US
Telephone Number	:	703-677-6413
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2020
Last Update Date	:	10/08/2020

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