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NPI Code Detail

MEDICARE: SOFIA MOREIRA RBT

MEDICARE: SOFIA MOREIRA RBT
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 : 1639806037
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOFIA MOREIRA RBT
Provider Business Mailing Address
First Line : 8558 BLACK STAR CIR
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-2649
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8558 BLACK STAR CIR
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-2649
Country : US
Telephone Number : 240-374-3368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2022
Last Update Date : 08/04/2022

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Directions to “ SOFIA MOREIRA RBT” Practice Location

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