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NPI Code Detail

MEDICARE: MARYAH MUMFORD

MEDICARE: MARYAH MUMFORD
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1851263123
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYAH MUMFORD
Provider Business Mailing Address
First Line : 101 RIBBON LN APT A
Second Line :
City : CARY
State : NC
Zip : 27518-6882
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8521 SIX FORKS RD STE 350
Second Line :
City : RALEIGH
State : NC
Zip : 27615-5863
Country : US
Telephone Number : 919-325-0952
Fax Number : 800-349-8941
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2025
Last Update Date : 02/06/2026

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