Most Relevant Information
Provider Data
| NPI Number: | 1003414533 |
| Provider Name: | MACIE A ANDERSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/16/2020 |
| Last Updated: | 06/21/2021 |
Provider Practice Location
238 S MERIDIAN RD
YOUNGSTOWN
OH
445092925
Practice Location Phone/Fax
| Phone: | 3303183436 |
| Fax: |
Provider Mailing Location
238 S MERIDIAN RD
YOUNGSTOWN
OH
445092925
Provider Mailing Phone/Fax
| Phone: | 3303183436 |
| Fax: |