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NPI Code Detail

MEDICARE: ADENDA FERGUSON BCBA, LBA

MEDICARE: ADENDA FERGUSON BCBA, LBA
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
1103K00000XBehavior Analyst1-18-33718

General Provider Information

NPI Number : 1548706583
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADENDA FERGUSON BCBA, LBA
Provider Business Mailing Address
First Line : 500 REDLAND CT STE 102
Second Line :
City : OWINGS MILLS
State : MD
Zip : 21117-3265
Country : US
Telephone Number : 443-738-5110
Fax Number :
Provider Business Practice Location Address
First Line : 500 REDLAND CT STE 102
Second Line :
City : OWINGS MILLS
State : MD
Zip : 21117-3265
Country : US
Telephone Number : 443-738-5110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2017
Last Update Date : 02/27/2025

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