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General NPI Number Information
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NPI Number | 1134938582
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Entity Type | Organization
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Legal Business Name | BRAIN SPARK LEARNING CENTER
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 4803 SPRINGMAID LN
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City | OXON HILL
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State | MD
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Zip | 20745-3471
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Country | US
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Telephone | 678-994-3197
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Fax |
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Provider Business Mailing Address
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Address Line | 245 N. HIGHLAND AVE. NE STE 230 #822
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City | ATLANTA
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State | GA
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Zip | 30307
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Country | US
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Telephone | 678-994-3197
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | MISS ASHLEY HOUSTON-ISAAC
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Credential |
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Telephone | 678-994-3197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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