Provider Demographics
NPI:1811213507
Name:PROGRESS AND LEARNING AUTISM NETWORK
Entity Type:Organization
Organization Name:PROGRESS AND LEARNING AUTISM NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:MIRANDA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:CLANEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA
Authorized Official - Phone:703-969-7336
Mailing Address - Street 1:706 W PATRICK ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4030
Mailing Address - Country:US
Mailing Address - Phone:703-727-5174
Mailing Address - Fax:301-378-0899
Practice Address - Street 1:706 W PATRICK ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4030
Practice Address - Country:US
Practice Address - Phone:703-727-5174
Practice Address - Fax:301-378-0899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-20
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1084887103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty