MEDICARE: BETELEHEM YOHANNES GETAHUN M.A

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

General Provider Information

NPI Number	:	1023595857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETELEHEM YOHANNES GETAHUN M.A

Provider Business Mailing Address
First Line	:	509 QUINCE ORCHARD ROAD
Second Line	:	SUITE 205
City	:	GAITHERSBURG
State	:	MD
Zip	:	20878-1435
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	509 QUINCE ORCHARD ROAD
Second Line	:	SUITE 205
City	:	GAITHERSBURG
State	:	MD
Zip	:	20878-1435
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

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

Provider Enumeration Date	:	07/24/2018
Last Update Date	:	10/04/2025

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