Provider Demographics
NPI:1477977858
Name:BILITZER, IFAT (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:IFAT
Middle Name:
Last Name:BILITZER
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 ROLAND HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1210
Mailing Address - Country:US
Mailing Address - Phone:240-543-8289
Mailing Address - Fax:866-857-0246
Practice Address - Street 1:1651 OLD MEADOW RD
Practice Address - Street 2:SUITE 600
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-4311
Practice Address - Country:US
Practice Address - Phone:443-863-6949
Practice Address - Fax:866-857-0246
Is Sole Proprietor?:No
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000152103K00000X
MD1-12-10102103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst