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General NPI Number Information
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NPI Number | 1356911580
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Entity Type | Organization
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Legal Business Name | DISCOVERY ABA MD LLC
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Dates
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Enumeration Date | 06/29/2021
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Last Update Date | 07/06/2021
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Provider Practice Location Address
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Address Line | 15 WALKER AVE STE 103
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City | PIKESVILLE
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State | MD
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Zip | 21208-4023
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Country | US
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Telephone | 704-561-1143
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Fax |
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Provider Business Mailing Address
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Address Line | 945 N CENTRAL AVE STE 201
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City | WOODMERE
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State | NY
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Zip | 11598-1604
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Country | US
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Telephone | 704-561-1143
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MARK ELIAS
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Credential |
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Telephone | 718-736-5689
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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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