Alexander Boulter
Individual provider Active NPI Behavior Technician · Perry Hall, MD
NPI 1104491448 · NPPES record last updated Apr 20, 2023
Key facts
- NPI
- 1104491448
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-20-111304 (MD)
- Practice address
- 9096 Rexis Ave
Perry Hall, MD 21128-9021 - Phone
- (443) 453-2031
- Fax
- (443) 216-7397
- NPI assigned
- May 20, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-111304 | MD | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advancing Abilities, LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician |
106S00000X | RBT-20-111304 | MD | Yes |
Addresses
Primary practice location
9096 Rexis Ave
Perry Hall, MD 21128-9021
Mailing address
308 Folcroft St
Baltimore, MD 21224-2801
Phone (443) 453-2031
Other providers in Perry Hall, MD
- Kerri Fleshia Best-Sule
- Bhes LLC
- Katie Bielas
- Latasha Bishop
- Sarah Elizabeth Blanchard
- Lisa Brown
- Bunna Transportation, LLC
- Joelle Babula Butler
- C and C Loving Heart Health Care Agency
- Kristian Anthony Casala
All providers in Perry Hall, MD · Behavior Technician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.