MEDICARE: GRACE MAHER

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	1-26-88011	TX

General Provider Information

NPI Number	:	1568242170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE MAHER

Provider Business Mailing Address
First Line	:	11623 ANGUS RD # E20
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-4003
Country	:	US
Telephone Number	:	970-980-7782
Fax Number	:

Provider Business Practice Location Address
First Line	:	11623 ANGUS RD # E20
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-4003
Country	:	US
Telephone Number	:	970-980-7782
Fax Number	:

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

Provider Enumeration Date	:	10/02/2023
Last Update Date	:	03/03/2026

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Directions to “ GRACE MAHER ” Practice Location

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