Most Relevant Information
Provider Data
| NPI Number: | 1003389867 |
| Provider Name: | TIA HENNIGAN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/04/2019 |
| Last Updated: | 01/04/2019 |
Provider Practice Location
7529 STANDISH PL # 355
ROCKVILLE
MD
208552733
Practice Location Phone/Fax
| Phone: | 7036365418 |
| Fax: |
Provider Mailing Location
7529 STANDISH PL # 355
ROCKVILLE
MD
208552733
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |