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NPI Code Detail

MEDICARE: REAGAN DANIELLE MINEAR BCBA

MEDICARE: REAGAN DANIELLE MINEAR BCBA
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
2103K00000XBehavior Analyst1-18-33675TX

General Provider Information

NPI Number : 1821500471
Entity Type Code : Individual
Provider Name (Legal Business Name) : REAGAN DANIELLE MINEAR BCBA
Provider Business Mailing Address
First Line : 5843 CLEARWATER CT
Second Line :
City : THE COLONY
State : TX
Zip : 75056-3868
Country : US
Telephone Number : 832-654-4489
Fax Number :
Provider Business Practice Location Address
First Line : 8400 STACY RD STE 300
Second Line :
City : MCKINNEY
State : TX
Zip : 75070-2144
Country : US
Telephone Number : 832-654-4489
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2017
Last Update Date : 01/24/2019

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