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NPI Code Detail

MEDICARE: REBECCA ADELE ROSLAN BCBA

MEDICARE: REBECCA ADELE ROSLAN BCBA
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
1103K00000XBehavior Analyst1-21-52299OH

General Provider Information

NPI Number : 1497342661
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA ADELE ROSLAN BCBA
Provider Business Mailing Address
First Line : 2 VILLAGE SQ STE 210
Second Line :
City : BALTIMORE
State : MD
Zip : 21210-1624
Country : US
Telephone Number : 614-844-5433
Fax Number : 614-987-8643
Provider Business Practice Location Address
First Line : 6660 DOUBLETREE AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43229-1128
Country : US
Telephone Number : 614-844-5433
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2020
Last Update Date : 02/13/2024

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Directions to “ REBECCA ADELE ROSLAN BCBA” Practice Location

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