MEDICARE: SPRING MONET MASON-STEWART

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	:	1568196491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SPRING MONET MASON-STEWART

Provider Business Mailing Address
First Line	:	5207 BRIDLE DR
Second Line	:
City	:	KILLEEN
State	:	TX
Zip	:	76549-5002
Country	:	US
Telephone Number	:	254-245-2544
Fax Number	:

Provider Business Practice Location Address
First Line	:	3009 SAULSBURY DR
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76504-2273
Country	:	US
Telephone Number	:	254-732-2262
Fax Number	:

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

Provider Enumeration Date	:	07/15/2022
Last Update Date	:	07/15/2022

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Directions to “ SPRING MONET MASON-STEWART ” Practice Location

Language	Start Address	Practice Location

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