Shelby Nicole Macananny, RBT

Individual provider Active NPI Behavior Technician · Marriottsville, MD

NPI 1104537307 · NPPES record last updated Dec 8, 2022

Key facts

NPI
1104537307
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
2470 Longstone LN Ste M
Marriottsville, MD 21104-1515
Phone
(410) 307-3182
NPI assigned
Dec 8, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

2470 Longstone LN Ste M
Marriottsville, MD 21104-1515

Mailing address

2470 Longstone LN
Marriottsville, MD 21104-1510

Other providers in Marriottsville, MD

All providers in Marriottsville, MD · Behavior Technician in Maryland

Sources for this page

Verify at the official NPI Registry.