Maryssa Alford
Individual provider Active NPI Behavior Technician · Mason, OH
NPI 1104659333 · NPPES record last updated Aug 22, 2024
Key facts
- NPI
- 1104659333
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-24-352651 (OH)
- Practice address
- 7312 Central Parke Blvd
Mason, OH 45040-6802 - Phone
- (513) 402-1711
- Fax
- (317) 520-8200
- NPI assigned
- Aug 22, 2024
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-24-352651 | OH | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-24-352651 | OH | Yes |
Addresses
Primary practice location
7312 Central Parke Blvd
Mason, OH 45040-6802
Mailing address
3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885
Other providers in Mason, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 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.