Provider Demographics
NPI:1447805718
Name:PRINCE, ROBIN (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:PRINCE
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7090 SAMUEL MORSE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3444
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 BETHESDA METRO CTR STE 700
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-6300
Practice Address - Country:US
Practice Address - Phone:240-292-8319
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-20-43143103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst