Healthcare Provider Details

I. General information

NPI: 1285344101
Provider Name (Legal Business Name): BELTWAY ABA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2022
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5825 UNIVERSITY RESEARCH CT STE 2000
COLLEGE PARK MD
20737-0019
US

IV. Provider business mailing address

5825 UNIVERSITY RESEARCH CT STE 2000
COLLEGE PARK MD
20737-0019
US

V. Phone/Fax

Practice location:
  • Phone: 240-923-4944
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARISA N GRUBER
Title or Position: OWNER
Credential: BCBA
Phone: 248-990-4080