Blue Balloon Indian Creek LLC

NPI #1073365243 in Beltsville, Maryland

Provider Information

NPI Number: 1073365243
Entity Type: Organization
Organization Name: Blue Balloon Indian Creek LLC
Primary Specialty: Behavior Analyst
Enumeration Date: Apr 2, 2024
Last Updated: Apr 2, 2024

Practice Location

Address: 12240 INDIAN CREEK CT STE 100
City: Beltsville
State: Maryland
ZIP Code: 20705-1242
Phone: (201) 216-9500

Authorized Official

Name: MS. MARIAM NEWMARK, M.ED, BCBA, LBA
Title: CLINICAL DIRECTOR
Phone: (201) 216-9500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X
Behavior Analyst	103K00000X	Primary

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