Healthcare Provider Details
I. General information
NPI: 1114422433
Provider Name (Legal Business Name): CYDNY GREY
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/28/2018
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 INTERNATIONAL CIR
HUNT VALLEY MD
21030-1304
US
IV. Provider business mailing address
8865 NORWIN AVE STE 27
NORTH HUNTINGDON PA
15642-2769
US
V. Phone/Fax
- Phone: 866-287-2036
- Fax:
- Phone: 724-263-1805
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: