Healthcare Provider Details

I. General information

NPI: 1487246260
Provider Name (Legal Business Name): FUNMILAYO HARRIS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAYO HARRIS BCBA

II. Dates (important events)

Enumeration Date: 02/03/2021
Last Update Date: 03/24/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7090 SAMUEL MORSE DR STE 100-300
COLUMBIA MD
21046-3442
US

IV. Provider business mailing address

13002 TAMARACK RD
SILVER SPRING MD
20904-1543
US

V. Phone/Fax

Practice location:
  • Phone: 855-935-3691
  • Fax:
Mailing address:
  • Phone: 202-322-7958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: