| Foundations Aba LLC | |
|
7 Gwynns Mill Ct Ste I Owings Mills MD 21117-3528 | |
| (404) 502-6868 | |
| Not Available |
| Full Name | Foundations Aba LLC |
|---|---|
| Speciality | Behavior Analyst |
| Location | 7 Gwynns Mill Ct Ste I, Owings Mills, Maryland |
| Authorized Official Name and Position | Kenneth Wise (OWNER) |
| Authorized Official Contact | 4045026868 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Foundations Aba LLC 2405 Steele Rd Baltimore MD 21209-3924 Ph: (202) 706-5646 | Foundations Aba LLC 7 Gwynns Mill Ct Ste I Owings Mills MD 21117-3528 Ph: (404) 502-6868 |
| NPI Number | 1255162434 |
|---|---|
| Provider Enumeration Date | 08/09/2024 |
| Last Update Date | 08/12/2024 |
| Certification Date | 08/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255162434 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (NU) | Secondary |
| 103K00000X | Behavior Analyst | (NU) | Primary |
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