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General NPI Number Information
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NPI Number | 1518890524
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Entity Type | Organization
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Legal Business Name | AUTASTIC ABA THERAPY
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 1945 W LEXINGTON ST
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City | BALTIMORE
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State | MD
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Zip | 21223-1652
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Country | US
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Telephone | 301-832-0045
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Fax |
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Provider Business Mailing Address
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Address Line | 6911 LAUREL BOWIE RD STE 309
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City | BOWIE
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State | MD
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Zip | 20715-1712
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Country | US
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Telephone | 202-425-9513
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TAMARA A PARKER
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Credential |
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Telephone | 301-755-4021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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