MEDICARE: CHRISTINE POPADICH 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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1619420437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE POPADICH BCBA

Provider Business Mailing Address
First Line	:	3013 BIRCHTREE LN
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-3035
Country	:	US
Telephone Number	:	717-756-9395
Fax Number	:

Provider Business Practice Location Address
First Line	:	3013 BIRCHTREE LN
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-3035
Country	:	US
Telephone Number	:	717-756-9395
Fax Number	:

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

Provider Enumeration Date	:	07/28/2016
Last Update Date	:	07/28/2016

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