MEDICARE: LARABA MOHAMMED

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	106S00000X	Behavior Technician	1366241119	MD

General Provider Information

NPI Number	:	1366241119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARABA MOHAMMED

Provider Business Mailing Address
First Line	:	2501 SMITH AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21209-2505
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2501 SMITH AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21209-2505
Country	:	US
Telephone Number	:	401-205-9493
Fax Number	:

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

Provider Enumeration Date	:	03/12/2025
Last Update Date	:	01/26/2026

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Directions to “ LARABA MOHAMMED ” Practice Location

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