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NPI Code Detail

MEDICARE: MARY MCDANIEL

MEDICARE: MARY MCDANIEL
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1568109312
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY MCDANIEL
Provider Business Mailing Address
First Line : 806 TOWNE PARK DR STE 100
Second Line :
City : RINCON
State : GA
Zip : 31326-9369
Country : US
Telephone Number : 912-429-7931
Fax Number :
Provider Business Practice Location Address
First Line : 806 TOWNE PARK DR STE 100
Second Line :
City : RINCON
State : GA
Zip : 31326-9369
Country : US
Telephone Number : 912-429-7931
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2022
Last Update Date : 12/05/2024

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Directions to “ MARY MCDANIEL ” Practice Location

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