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NPI Code Detail

MEDICARE: DR. MARY CARUSO-ANDERSON PH.D., BCBA

MEDICARE:  DR. MARY  CARUSO-ANDERSON  PH.D., 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
1103TM1800XIntellectual & Developmental Disabilities Psychologist

General Provider Information

NPI Number : 1598967408
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY CARUSO-ANDERSON PH.D., BCBA
Provider Business Mailing Address
First Line : 2018 BANK ST
Second Line :
City : BALTIMORE
State : MD
Zip : 21231
Country : US
Telephone Number : 443-804-8493
Fax Number :
Provider Business Practice Location Address
First Line : 9722 GROFFS MILL DR STE 726
Second Line :
City : OWINGS MILLS
State : MD
Zip : 21117-6341
Country : US
Telephone Number : 888-428-3223
Fax Number : 323-866-1881
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2007
Last Update Date : 01/29/2021

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Directions to “ DR. MARY CARUSO-ANDERSON PH.D., BCBA” Practice Location

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