MEDICARE: SHARON MCDANIEL BCBA

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

General Provider Information

NPI Number	:	1235927229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON MCDANIEL BCBA

Provider Business Mailing Address
First Line	:	500 MARINERS PLAZA DR STE 501
Second Line	:
City	:	MANDEVILLE
State	:	LA
Zip	:	70448-6851
Country	:	US
Telephone Number	:	985-260-1473
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 MARINERS PLAZA DR STE 501
Second Line	:
City	:	MANDEVILLE
State	:	LA
Zip	:	70448-6851
Country	:	US
Telephone Number	:	985-260-1473
Fax Number	:

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

Provider Enumeration Date	:	04/29/2025
Last Update Date	:	04/29/2025

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