Healthcare Provider Details

I. General information

NPI: 1609555853
Provider Name (Legal Business Name): ABA THERAPY AND ASSOCIATED SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2023
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2405 YORK RD STE 201
LUTHERVILLE TIMONIUM MD
21093-2252
US

IV. Provider business mailing address

1178 BROADWAY FL 3 #3381
NEW YORK NY
10001-5666
US

V. Phone/Fax

Practice location:
  • Phone: 917-284-9393
  • Fax: 917-284-9393
Mailing address:
  • Phone: 917-284-9393
  • Fax: 917-284-9393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. TESSA BROWER
Title or Position: CEO
Credential:
Phone: 617-335-0000