Provider Demographics
NPI:1326318122
Name:AUTISM ABA SERVICES OF MD
Entity Type:Organization
Organization Name:AUTISM ABA SERVICES OF MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:H
Authorized Official - Last Name:GURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA, LBA
Authorized Official - Phone:443-629-1096
Mailing Address - Street 1:1965 ANDREW CT
Mailing Address - Street 2:
Mailing Address - City:MARRIOTTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21104
Mailing Address - Country:US
Mailing Address - Phone:443-629-1096
Mailing Address - Fax:888-241-5905
Practice Address - Street 1:1965 ANDREW CT
Practice Address - Street 2:
Practice Address - City:MARRIOTTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21104
Practice Address - Country:US
Practice Address - Phone:443-629-1096
Practice Address - Fax:888-241-5905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1073277103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty