MEDICARE: SHAYEENA MOHAMED

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1316778616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAYEENA MOHAMED

Provider Business Mailing Address
First Line	:	9 BANKS AVE
Second Line	:
City	:	MCADOO
State	:	PA
Zip	:	18237-2508
Country	:	US
Telephone Number	:	570-802-3099
Fax Number	:

Provider Business Practice Location Address
First Line	:	9250 GAITHER RD
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20877-1420
Country	:	US
Telephone Number	:	301-337-8811
Fax Number	:

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

Provider Enumeration Date	:	08/09/2024
Last Update Date	:	03/29/2026

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