Miranda Marie Grandolf

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

8188 Horton Hwy
College Grove, TN 37046-9179

Phone

(615) 714-2290

NPI assigned

Aug 7, 2024

Last updated

Aug 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1508696006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8188 HORTON HWY",
            "city": "COLLEGE GROVE",
            "state": "TN",
            "postal_code": "370469179",
            "telephone_number": "615-714-2290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8188 HORTON HWY",
            "city": "COLLEGE GROVE",
            "state": "TN",
            "postal_code": "370469179",
            "telephone_number": "615-714-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDOLF",
        "first_name": "MIRANDA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in College Grove, TN
• Providers in College Grove, TN by specialty
• Behavior Technician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.