Healthcare Provider Details

I. General information

NPI: 1023912227
Provider Name (Legal Business Name): THEIR OWN WAY BEHAVIORAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 WELLHAM AVE
GLEN BURNIE MD
21061-2309
US

IV. Provider business mailing address

711 WELLHAM AVE
GLEN BURNIE MD
21061-2309
US

V. Phone/Fax

Practice location:
  • Phone: 301-659-8842
  • Fax:
Mailing address:
  • Phone: 301-659-8842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: MONIQUE LABASTIDA
Title or Position: BCBA
Credential: BCBA
Phone: 301-659-8842