Provider Demographics
NPI:1609367499
Name:FURLOW, AMY GUTWEIN (MA BCBA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:GUTWEIN
Last Name:FURLOW
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 1:853 HAZEL TRL
Mailing Address - Street 2:
Mailing Address - City:CROWNSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21032-1822
Mailing Address - Country:US
Mailing Address - Phone:443-994-5313
Mailing Address - Fax:
Practice Address - Street 1:853 HAZEL TRL
Practice Address - Street 2:
Practice Address - City:CROWNSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21032-1822
Practice Address - Country:US
Practice Address - Phone:443-994-5313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1-17-27920103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst