MEDICARE: SHANEA JASMINE NEAL

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	RBT-25-416916	MD

General Provider Information

NPI Number	:	1326914763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANEA JASMINE NEAL

Provider Business Mailing Address
First Line	:	2 MILBERT CT # 2A
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21228-4529
Country	:	US
Telephone Number	:	443-460-8709
Fax Number	:

Provider Business Practice Location Address
First Line	:	5740 EXECUTIVE DR STE 114
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21228-1331
Country	:	US
Telephone Number	:	410-609-6357
Fax Number	:

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

Provider Enumeration Date	:	10/14/2025
Last Update Date	:	10/14/2025

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