MEDICARE: BETHANY L. CONDO-ALOBAID BCBA

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	:	1316377138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETHANY L. CONDO-ALOBAID BCBA

Provider Business Mailing Address
First Line	:	20400 OBSERVATION DR STE 104
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20876-4086
Country	:	US
Telephone Number	:	814-449-9437
Fax Number	:

Provider Business Practice Location Address
First Line	:	20400 OBSERVATION DR STE 104
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20876-4086
Country	:	US
Telephone Number	:	301-540-0445
Fax Number	:

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

Provider Enumeration Date	:	11/14/2013
Last Update Date	:	12/30/2024

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