Provider Demographics
NPI:1649669656
Name:WELLS, LAYNE A (BCBA)
Entity type:Individual
Prefix:MRS
First Name:LAYNE
Middle Name:A
Last Name:WELLS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 SUDBROOK LN
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4727
Mailing Address - Country:US
Mailing Address - Phone:484-832-4702
Mailing Address - Fax:
Practice Address - Street 1:11500 CRONRIDGE DR
Practice Address - Street 2:STE. 130
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-2261
Practice Address - Country:US
Practice Address - Phone:443-641-3277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst