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NPI Code Detail

MEDICARE: MARKAYLA SHANAE GORDON

MEDICARE: MARKAYLA SHANAE GORDON
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 : 1649073172
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARKAYLA SHANAE GORDON
Provider Business Mailing Address
First Line : 2000 TOWER OAKS BLVD STE 500
Second Line :
City : ROCKVILLE
State : MD
Zip : 20852-4377
Country : US
Telephone Number : 301-444-5001
Fax Number :
Provider Business Practice Location Address
First Line : 7175 COLUMBIA GATEWAY DR STE A
Second Line :
City : COLUMBIA
State : MD
Zip : 21046-2536
Country : US
Telephone Number : 888-344-5977
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2025
Last Update Date : 03/17/2026

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Directions to “ MARKAYLA SHANAE GORDON ” Practice Location

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