MEDICARE: MIRANDA NICHOLE COURY

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	BH007671	PA

General Provider Information

NPI Number	:	1013709252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRANDA NICHOLE COURY

Provider Business Mailing Address
First Line	:	106 ZEE PLZ
Second Line	:
City	:	HOLLIDAYSBURG
State	:	PA
Zip	:	16648-1003
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 ZEE PLZ
Second Line	:
City	:	HOLLIDAYSBURG
State	:	PA
Zip	:	16648-1003
Country	:	US
Telephone Number	:	814-788-2109
Fax Number	:

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

Provider Enumeration Date	:	05/22/2025
Last Update Date	:	05/22/2025

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Directions to “ MIRANDA NICHOLE COURY ” Practice Location

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