=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962151282
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERCILIA MIGUELINA O'NEAL BCBA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2022
-----------------------------------------------------
Last Update Date | 01/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5740 EXECUTIVE DR STE 114-122
-----------------------------------------------------
City | CATONSVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21228-1766
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-885-2705
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1453 COVENTRY DR APT 8
-----------------------------------------------------
City | HANOVER
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21076-5027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-325-3411
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number | 1-24-77013
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------