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NPI Code Detail

MEDICARE: SETH MCBRIDE

MEDICARE: SETH MCBRIDE
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 : 1962280735
Entity Type Code : Individual
Provider Name (Legal Business Name) : SETH MCBRIDE
Provider Business Mailing Address
First Line : 2103 N DOUGLASS ST
Second Line :
City : MALDEN
State : MO
Zip : 63863-1141
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2103 N DOUGLASS ST
Second Line :
City : MALDEN
State : MO
Zip : 63863-1141
Country : US
Telephone Number : 573-888-5925
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2023
Last Update Date : 09/21/2023

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Directions to “ SETH MCBRIDE ” Practice Location

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