Provider Demographics
NPI:1033791272
Name:FARRELL, AUBRI SUMMER (RBT)
Entity Type:Individual
Prefix:MRS
First Name:AUBRI
Middle Name:SUMMER
Last Name:FARRELL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11266 GARLAND RD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629-3253
Mailing Address - Country:US
Mailing Address - Phone:410-829-3425
Mailing Address - Fax:
Practice Address - Street 1:11266 GARLAND RD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-3253
Practice Address - Country:US
Practice Address - Phone:410-829-3425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRBT-21-158982106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician