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General NPI Number Information
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NPI Number | 1447653688
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Entity Type | Organization
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Legal Business Name | APPLIED BEHAVIOR SERVICES
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Dates
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Enumeration Date | 10/02/2014
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Last Update Date | 10/02/2014
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Provider Practice Location Address
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Address Line | 405 KERSTEN ST
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City | GAITHERSBURG
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State | MD
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Zip | 20878-6514
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Country | US
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Telephone | 202-330-7780
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Fax | 301-263-7493
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Provider Business Mailing Address
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Address Line | 405 KERSTEN ST
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City | GAITHERSBURG
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State | MD
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Zip | 20878-6514
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Country | US
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Telephone | 202-330-7780
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Fax | 301-263-7493
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Authorized Official
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Title or Position | OWNER
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Name | FERNANDA JARAMILLO
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Credential | BCBA, LCPC
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Telephone | 202-330-7780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LC3662
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License Number State | MD
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