Provider Demographics
NPI:1598967408
Name:CARUSO-ANDERSON, MARY (PHD, BCBA)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:CARUSO-ANDERSON
Suffix:
Gender:F
Credentials:PHD, BCBA
Other - Prefix:DR
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:CARUSO-ANDERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, BCBA
Mailing Address - Street 1:2018 BANK ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231
Mailing Address - Country:US
Mailing Address - Phone:443-804-8493
Mailing Address - Fax:
Practice Address - Street 1:9722 GROFFS MILL DR STE 726
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-6341
Practice Address - Country:US
Practice Address - Phone:888-428-3223
Practice Address - Fax:323-866-1881
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities