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NPI Code Detail

MEDICARE: MRS. MIRANDA CHRISTINE CLANEY M.A, BCBA

MEDICARE: MRS. MIRANDA CHRISTINE CLANEY M.A, 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
1103K00000XBehavior Analyst1-08-4887MD

General Provider Information

NPI Number : 1952542763
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MIRANDA CHRISTINE CLANEY M.A, BCBA
Provider Business Mailing Address
First Line : 706 W PATRICK ST
Second Line :
City : FREDERICK
State : MD
Zip : 21701-4030
Country : US
Telephone Number : 301-882-7932
Fax Number : 301-500-2173
Provider Business Practice Location Address
First Line : 706 W PATRICK ST
Second Line :
City : FREDERICK
State : MD
Zip : 21701-4030
Country : US
Telephone Number : 703-727-5174
Fax Number : 301-500-2173
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2009
Last Update Date : 11/09/2020

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