Provider Demographics
NPI:1588029417
Name:SEVON, MAWULE (MA, NCSP, BCBA)
Entity Type:Individual
Prefix:
First Name:MAWULE
Middle Name:
Last Name:SEVON
Suffix:
Gender:F
Credentials:MA, NCSP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8609 2ND AVE
Mailing Address - Street 2:404B
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3360
Mailing Address - Country:US
Mailing Address - Phone:240-398-3514
Mailing Address - Fax:
Practice Address - Street 1:8609 2ND AVE
Practice Address - Street 2:404B
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3360
Practice Address - Country:US
Practice Address - Phone:240-398-3514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-18
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD45863103TS0200X
MD0-16-21415103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst