Jessica Miranda Chisenall
Individual provider Active NPI Behavior Technician · Cedartown, GA
NPI 1992685804 · NPPES record last updated Sep 3, 2025
Key facts
- NPI
- 1992685804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 711 Canal CT Apt 5
Cedartown, GA 30125-3500 - Phone
- (404) 988-9731
- NPI assigned
- Sep 3, 2025
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | GA | Yes |
Addresses
Primary practice location
711 Canal CT Apt 5
Cedartown, GA 30125-3500
Mailing address
711 Canal CT Apt 5
Cedartown, GA 30125-3500
Other names
- Miranda Chisenall
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All providers in Cedartown, GA · Behavior Technician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2025. 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.