Deitra Cornish
Individual provider Active NPI Behavior Technician · Rockville, MD
NPI 1558049809 · NPPES record last updated Jul 7, 2023
Key facts
- NPI
- 1558049809
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 2000 Tower Oaks Blvd Ste 500
Rockville, MD 20852-4377 - Phone
- (301) 444-5001
- NPI assigned
- Jul 7, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
2000 Tower Oaks Blvd Ste 500
Rockville, MD 20852-4377
Mailing address
2000 Tower Oaks Blvd Ste 500
Rockville, MD 20852-4377
Phone (301) 444-5001
Other providers in Rockville, MD
- Cornerstone Montgomery, Inc.
- Cornerstone Montgomery, Inc.
- Cornerstone Montgomery, Inc.
- Gyraldi Cornielle Caminero
- Cydia Cornish
- Percella Cornish
- Carrie Cornwell
- Dorshawna Corprew
- Ebony Corprew
- Anne-Marie Corrado
All providers in Rockville, 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 Jul 7, 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.