MEDICARE: MARIAH REID 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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1851956908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAH REID BCBA

Provider Business Mailing Address
First Line	:	1901 E REDFIELD RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-4545
Country	:	US
Telephone Number	:	602-423-0161
Fax Number	:

Provider Business Practice Location Address
First Line	:	2225 N 16TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-1823
Country	:	US
Telephone Number	:	602-340-8720
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2019
Last Update Date	:	06/10/2022

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Directions to “ MARIAH REID BCBA” Practice Location

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