Healthcare Provider Details

I. General information

NPI: 1003446980
Provider Name (Legal Business Name): MARC STRAWDERMAN ED.D., BSL, LBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MARANATHA THOMAS

II. Dates (important events)

Enumeration Date: 01/20/2020
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 WESTPORT AVE
NORWALK CT
06851-3915
US

IV. Provider business mailing address

168 JENNIFER DR
NEW OXFORD PA
17350-9225
US

V. Phone/Fax

Practice location:
  • Phone: 713-936-2790
  • Fax:
Mailing address:
  • Phone: 717-398-8828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number9938
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: