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NPI Code Detail

MEDICARE: MARY BETH MCANDREW

MEDICARE:   MARY BETH MCANDREW
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
1103K00000XBehavior Analyst1-17-27465CO

General Provider Information

NPI Number : 1760916399
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY BETH MCANDREW
Provider Business Mailing Address
First Line : 1058 S DAHLIA ST
Second Line : APT A41
City : GLENDALE
State : CO
Zip : 80246-5461
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1058 S DAHLIA ST
Second Line : APT A41
City : GLENDALE
State : CO
Zip : 80246
Country : US
Telephone Number : 252-717-4148
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2017
Last Update Date : 10/09/2017

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Directions to “ MARY BETH MCANDREW ” Practice Location

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