=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992251052
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANNIE MCLAUGHLIN CONSULTING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/29/2016
-----------------------------------------------------
Last Update Date | 08/29/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2036 E PRATT ST
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21231-1934
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-630-1209
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2036 E PRATT ST
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21231-1934
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CONSTANCE MCLAUGHLIN
-----------------------------------------------------
Credential | PHD BCBA-D
-----------------------------------------------------
Telephone | 410-630-1209
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number | BA-0032
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------