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General NPI Number Information
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NPI Number | 1326914763
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Entity Type | Individual
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Provider Name | SHANEA JASMINE NEAL
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Gender | Female
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 5740 EXECUTIVE DR STE 114
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City | BALTIMORE
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State | MD
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Zip | 21228-1331
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Country | US
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Telephone | 410-609-6357
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Fax |
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Provider Business Mailing Address
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Address Line | 2 MILBERT CT # 2A
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City | BALTIMORE
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State | MD
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Zip | 21228-4529
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Country | US
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Telephone | 443-460-8709
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-25-416916
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License Number State | MD
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