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General NPI Number Information
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NPI Number | 1568731529
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Entity Type | Organization
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Legal Business Name | PERCEIVE IT, LLC
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Dates
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Enumeration Date | 12/21/2011
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Last Update Date | 12/21/2011
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Provider Practice Location Address
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Address Line | 4550 FORBES BLVD SUITE 320
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City | LANHAM
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State | MD
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Zip | 20706-4394
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Country | US
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Telephone | 301-552-5658
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Fax | 301-552-8830
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Provider Business Mailing Address
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Address Line | 4550 FORBES BLVD SUITE 320
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City | LANHAM
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State | MD
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Zip | 20706-6309
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Country | US
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Telephone | 301-552-5658
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Fax | 301-552-8830
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Authorized Official
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Title or Position | OWNER
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Name | DARLENE CYNTHIA IFILL-TAYLOR
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Credential | M.D.
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Telephone | 301-552-5658
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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 | D0038044
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License Number State | MD
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