Miranda Brister
Individual provider Active NPI Behavior Analyst · Hattiesburg, MS
NPI 1639555477 · NPPES record last updated Aug 4, 2015
Key facts
- NPI
- 1639555477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 20 Parkway Blvd
Hattiesburg, MS 39401-8879 - Phone
- (601) 255-5264
- NPI assigned
- Aug 4, 2015
- Sex
- Female
- Sole proprietor
- Yes
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
20 Parkway Blvd
Hattiesburg, MS 39401-8879
Mailing address
20 Parkway Blvd
Hattiesburg, MS 39401-8879
Other providers in Hattiesburg, MS
- Nancy C Bridges
- Brighter Horizons Therapy, LLC
- R. Alan Brinson
- Richard Scott Brinson
- Briomd Physicians
- Broader Spectrum Counseling PLLC
- Beyonce Brock
- Marty Jacob Brock
- Honey Brooks
- Shalisha Brooks
All providers in Hattiesburg, MS · Behavior Analyst in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2015. 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.