Miranda Gastineau
Individual provider Active NPI Behavior Technician · Coffeyville, KS
NPI 1043045891 · NPPES record last updated Sep 3, 2024
Key facts
- NPI
- 1043045891
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 2404 W 8TH St
Coffeyville, KS 67337-2931 - Phone
- (620) 330-9036
- Fax
- (620) 206-2514
- NPI assigned
- Sep 3, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Born to Blossom LLC | Behavior Technician | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
2404 W 8TH St
Coffeyville, KS 67337-2931
Mailing address
2404 W 8TH St
Coffeyville, KS 67337-2931
Phone (620) 330-9036
Other providers in Coffeyville, KS
- Amy D. Ford
- April Foreman
- Shravan Kumar Reddy Gangula
- Mark Gardner
- Gary Blaich D.D.S., P.a.
- Dara Tania Gibson
- Allen Dean Gillis
- Linda S Grover
- Alexandra Anatolyia Grunewald
- GV-Op Coffeyville LLC
All providers in Coffeyville, KS · Behavior Technician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.