Healthcare Provider Details

I. General information

NPI: 1073274684
Provider Name (Legal Business Name): THE LEARNING TREE ABA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2022
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 SMITH AVE
BALTIMORE MD
21209-2505
US

IV. Provider business mailing address

2501 SMITH AVE
BALTIMORE MD
21209-2505
US

V. Phone/Fax

Practice location:
  • Phone: 347-255-1388
  • Fax:
Mailing address:
  • Phone: 410-205-9493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: EVELYN FROMOWITZ
Title or Position: CEO
Credential: BCBA, LBA
Phone: 410-205-9493