Provider Demographics
NPI:1891419529
Name:CASON, DYLLON
Entity Type:Individual
Prefix:MR
First Name:DYLLON
Middle Name:
Last Name:CASON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 GARRISON BLVD APT 5A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21216-1867
Mailing Address - Country:US
Mailing Address - Phone:202-495-0713
Mailing Address - Fax:
Practice Address - Street 1:2910 GARRISON BLVD APT 5A
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-1867
Practice Address - Country:US
Practice Address - Phone:202-495-0713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD835809106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician