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General NPI Number Information
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NPI Number | 1194311324
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Entity Type | Organization
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Legal Business Name | SPECTRUM SUPPORT
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Dates
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Enumeration Date | 12/11/2020
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 2 HAMILL RD STE 225
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City | BALTIMORE
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State | MD
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Zip | 21210-1815
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Country | US
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Telephone | 443-360-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 302 E BELVEDERE AVE
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City | BALTIMORE
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State | MD
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Zip | 21212-3033
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Country | US
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Telephone | 228-223-6792
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOY F JOHNSON
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Credential | BCBA, LBA
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Telephone | 223-223-6792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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