Healthcare Provider Details

I. General information

NPI: 1538605548
Provider Name (Legal Business Name): PIERRE ANDRE BCBA, LBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2017
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13625 DEERWATER DR
GERMANTOWN MD
20874-2847
US

IV. Provider business mailing address

13625 DEERWATER DR
GERMANTOWN MD
20874-2847
US

V. Phone/Fax

Practice location:
  • Phone: 301-642-3118
  • Fax:
Mailing address:
  • Phone: 301-642-3118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA2731
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: