Provider Demographics
NPI:1427464742
Name:RAO MARTINELLO, SANJANA N (MA, BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:SANJANA
Middle Name:N
Last Name:RAO MARTINELLO
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:MISS
Other - First Name:SANJANA
Other - Middle Name:NIRANJAN
Other - Last Name:RAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, BCBA, LBA
Mailing Address - Street 1:2 VILLAGE SQ
Mailing Address - Street 2:STE 210
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1624
Mailing Address - Country:US
Mailing Address - Phone:866-565-7222
Mailing Address - Fax:877-734-1914
Practice Address - Street 1:1800 ALEXANDER BELL DR STE 100
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-4385
Practice Address - Country:US
Practice Address - Phone:866-565-7222
Practice Address - Fax:877-734-1914
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-14-15142103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst