Healthcare Provider Details

I. General information

NPI: 1336005222
Provider Name (Legal Business Name): ANASTASIA OBERNBERGER
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 BOSTON ST STE 240
BALTIMORE MD
21224-4976
US

IV. Provider business mailing address

3301 BOSTON ST STE 240
BALTIMORE MD
21224-4976
US

V. Phone/Fax

Practice location:
  • Phone: 240-342-2666
  • Fax:
Mailing address:
  • Phone: 240-342-2666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: