MEDICARE: ALLEN FLYNN

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	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst	LBA2640	MD

General Provider Information

NPI Number	:	1093454217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLEN FLYNN

Provider Business Mailing Address
First Line	:	7709 LEE DR
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-3228
Country	:	US
Telephone Number	:	443-883-0879
Fax Number	:

Provider Business Practice Location Address
First Line	:	7709 LEE DR
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-3228
Country	:	US
Telephone Number	:	443-883-0879
Fax Number	:

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

Provider Enumeration Date	:	06/04/2022
Last Update Date	:	06/01/2026

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Directions to “ ALLEN FLYNN ” Practice Location

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