MEDICARE: MS. MARIAH HALEY ANDERSON M.S., BCBA, LBA

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	2025035068	MO

General Provider Information

NPI Number	:	1245116953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIAH HALEY ANDERSON M.S., BCBA, LBA

Provider Business Mailing Address
First Line	:	PO BOX 843966
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64184-3966
Country	:	US
Telephone Number	:	573-884-3300
Fax Number	:	573-884-0943

Provider Business Practice Location Address
First Line	:	200 N KEENE ST BLDG 2
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65201-8143
Country	:	US
Telephone Number	:	573-884-6052
Fax Number	:	573-884-3195

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

Provider Enumeration Date	:	08/15/2025
Last Update Date	:	09/24/2025

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