Brandon Miranda

Individual provider Active NPI Behavior Technician · Burlington, KY

NPI 1205534856 · NPPES record last updated Feb 22, 2023

Key facts

NPI
1205534856
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
22-241828 (KY)
Practice address
1808 Bordeaux Blvd Apt V
Burlington, KY 41005-8569
Phone
(571) 340-1893
NPI assigned
Feb 22, 2023
Sex
Male
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

LicenseStateTypeSpecialty
22-241828KYMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 22-241828 KY Yes

Addresses

Primary practice location

1808 Bordeaux Blvd Apt V
Burlington, KY 41005-8569

Mailing address

1808 Bordeaux Blvd Apt V
Burlington, KY 41005-8569

Other providers in Burlington, KY

All providers in Burlington, KY · Behavior Technician in Kentucky

Sources for this page

Verify at the official NPI Registry.