Brenard Blackmon
Individual provider Active NPI Behavior Technician · Landover, MD
NPI 1821769738 · NPPES record last updated Sep 22, 2021
Key facts
- NPI
- 1821769738
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 8200 Professional PL Ste 115
Landover, MD 20785-2293 - Phone
- (240) 297-3550
- NPI assigned
- Sep 22, 2021
- Sex
- Male
- 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
8200 Professional PL Ste 115
Landover, MD 20785-2293
Mailing address
2550 N Hollywood Way Ste 102
Burbank, CA 91505-5031
Phone (866) 727-8274
Other providers in Landover, MD
- Dionne B Benjamin
- Phyllis Benjamin
- Amaya Bennett
- Keyonna Latarsha Berry
- La-Vora Better
- Martina Blake
- Blossom 24HR Home Care LLC
- Kendra Blue
- Akua Odi Boateng
- Pauline Boldin
All providers in Landover, 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 Sep 22, 2021. 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.