Healthcare Provider Details

I. General information

NPI: 1639596174
Provider Name (Legal Business Name): MAUREEN FOSS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2014
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 S STATE ST
DOVER DE
19901-4945
US

IV. Provider business mailing address

39 BANGOR ST
HOULTON ME
04730-1711
US

V. Phone/Fax

Practice location:
  • Phone: 302-244-3404
  • Fax: 855-596-2438
Mailing address:
  • Phone: 207-521-5230
  • Fax: 855-596-2438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133000410
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: