Healthcare Provider Details

I. General information

NPI: 1841750098
Provider Name (Legal Business Name): LEARNING OUTSIDE THE LINES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2019
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 ALYMER CT
WESTMINSTER MD
21157-6361
US

IV. Provider business mailing address

164 ALYMER CT
WESTMINSTER MD
21157-6361
US

V. Phone/Fax

Practice location:
  • Phone: 443-203-9707
  • Fax: 877-940-2717
Mailing address:
  • Phone: 443-203-9707
  • Fax: 877-940-2717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JOSSELYN ENSOR
Title or Position: CEO/BEHAVIOR ANALYST
Credential: MS ED, BCBA, LBA
Phone: 443-203-9707