Healthcare Provider Details

I. General information

NPI: 1033540737
Provider Name (Legal Business Name): MARY GRAHAM MCDOWELL MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2013
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 HARVARD ST
RUTLAND VT
05701-3631
US

IV. Provider business mailing address

8 HARVARD ST
RUTLAND VT
05701-3631
US

V. Phone/Fax

Practice location:
  • Phone: 802-855-3388
  • Fax:
Mailing address:
  • Phone: 802-855-3388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-12-12023
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: