Healthcare Provider Details

I. General information

NPI: 1992311724
Provider Name (Legal Business Name): ANNA MAUREEN SHERIDAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2020
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7120 SAMUEL MORSE DR STE 150
COLUMBIA MD
21046-3420
US

IV. Provider business mailing address

7120 SAMUEL MORSE DR STE 150
COLUMBIA MD
21046-3420
US

V. Phone/Fax

Practice location:
  • Phone: 888-344-5977
  • Fax:
Mailing address:
  • Phone: 888-344-5977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1648
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133003208
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: