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NPI Code Detail

MEDICARE: MS. AMANDA MORALES BCBA

MEDICARE: MS. AMANDA MORALES BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst935CT

General Provider Information

NPI Number : 1457986200
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMANDA MORALES BCBA
Provider Business Mailing Address
First Line : 4 RUDD PL
Second Line :
City : BRONX
State : NY
Zip : 10473-2233
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 30 BUXTON FARM RD STE 105
Second Line :
City : STAMFORD
State : CT
Zip : 06905-1210
Country : US
Telephone Number : 203-674-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2020
Last Update Date : 03/11/2020

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