MEDICARE: AMANDA ASHLEY BIONDY M.S., BCBA, LBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	29 290 369	PA

General Provider Information

NPI Number	:	1003157827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA ASHLEY BIONDY M.S., BCBA, LBA

Provider Business Mailing Address
First Line	:	2963 BALI DR
Second Line	:
City	:	MANCHESTER
State	:	MD
Zip	:	21102-1856
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7175 COLUMBIA GATEWAY DR
Second Line	:	STE A
City	:	COLUMBIA
State	:	MD
Zip	:	21046-2534
Country	:	US
Telephone Number	:	888-344-5977
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2013
Last Update Date	:	12/20/2016

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