Provider Demographics
NPI:1982263844
Name:PBD-KIDS, LLC
Entity Type:Organization
Organization Name:PBD-KIDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR BEHAVIOR ANALYTIC SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MAURO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA-D
Authorized Official - Phone:301-706-1848
Mailing Address - Street 1:1021 FOREST GLEN RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-2103
Mailing Address - Country:US
Mailing Address - Phone:301-706-1848
Mailing Address - Fax:
Practice Address - Street 1:1021 FOREST GLEN RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-2103
Practice Address - Country:US
Practice Address - Phone:301-706-1848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty