Basic Information
| Provider Information | |||||||||
| NPI: | 1073908687 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | ABBIGAIL | ||||||||
| MiddleName: | MAY | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.A., BCBA | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | LONG | ||||||||
| OtherFirstName: | ABBIGAIL | ||||||||
| OtherMiddleName: | MAY | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 9545 GEORGIA AVE | ||||||||
| Address2: | LITTLE LEAVES BEHAVIORAL SERVICES | ||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209101438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024208359 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9545 GEORGIA AVE | ||||||||
| Address2: | LITTLE LEAVES BEHAVIORAL SERVICES | ||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209101438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024208359 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2015 | ||||||||
| LastUpdateDate: | 03/31/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.