Provider Demographics
NPI:1588902472
Name:FARRIS, MAREN (MSED BCBA)
Entity type:Individual
Prefix:
First Name:MAREN
Middle Name:
Last Name:FARRIS
Suffix:
Gender:F
Credentials:MSED BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7512 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5707
Mailing Address - Country:US
Mailing Address - Phone:484-995-0860
Mailing Address - Fax:
Practice Address - Street 1:7512 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-5707
Practice Address - Country:US
Practice Address - Phone:484-995-0860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-28
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-10-7158103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst