Healthcare Provider Details

I. General information

NPI: 1679401400
Provider Name (Legal Business Name): SWEETBAY DEVELOPMENTAL THERAPIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 CALVERT RD
STEVENSVILLE MD
21666-2620
US

IV. Provider business mailing address

414 CALVERT RD
STEVENSVILLE MD
21666-2620
US

V. Phone/Fax

Practice location:
  • Phone: 443-871-4824
  • Fax: 443-458-1970
Mailing address:
  • Phone: 443-871-4824
  • Fax: 443-458-1970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JENNIFER KELLEY
Title or Position: OWNER
Credential: BCBA
Phone: 443-871-4824