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NPI Code Detail

MEDICARE: ALISHA PRUNTY

MEDICARE:   ALISHA  PRUNTY
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1639022809
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALISHA PRUNTY
Provider Business Mailing Address
First Line : 7375 EXECUTIVE PL STE 203
Second Line :
City : LANHAM
State : MD
Zip : 20706-6236
Country : US
Telephone Number : 202-207-0720
Fax Number :
Provider Business Practice Location Address
First Line : 7375 EXECUTIVE PL STE 203
Second Line :
City : LANHAM
State : MD
Zip : 20706-6236
Country : US
Telephone Number : 202-207-0720
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2026
Last Update Date : 02/18/2026

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Directions to “ ALISHA PRUNTY ” Practice Location

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