Healthcare Provider Details

I. General information

NPI: 1821674243
Provider Name (Legal Business Name): M2N INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 03/24/2021
Certification Date: 02/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 S. BRAND BLVD
GLENDALE CA
91204
US

IV. Provider business mailing address

127 S. BRAND BLVD
GLENDALE CA
91204
US

V. Phone/Fax

Practice location:
  • Phone: 747-215-9143
  • Fax: 747-297-4497
Mailing address:
  • Phone: 747-215-9143
  • Fax: 747-297-4497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. NANOOR SHAHIN
Title or Position: CLINICAL DIRECTOR / VICE PRESIDENT
Credential: M.A. , BCBA
Phone: 818-926-1005