Vivian A Mendoza, BA, M.ED
Individual provider Active NPI Behavior Technician · Owning Mills, MD
NPI 1740697481 · NPPES record last updated Jul 17, 2023
Key facts
- NPI
- 1740697481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 9722 Groffs Mill Dr
Ste 766
Owning Mills, MD 21117 - Phone
- (410) 205-9255
- NPI assigned
- Jul 15, 2014
- 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
- Credentials
- Bachelor of Arts, Master of Education
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
9722 Groffs Mill Dr
Ste 766
Owning Mills, MD 21117
Mailing address
722 Groffs Mill Dr
Ste 766
Owning Mills, MD 21117
Phone (410) 216-1499
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2023. 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.