Individual
DR. MIRANDA B. KOGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, D.BH
Contact information
Practice address
3333 UNIVERSITY BLVD W APT 608, KENSINGTON, MD 20895-1834
(845) 546-4216
Mailing address
3333 UNIVERSITY BLVD W APT 608, KENSINGTON, MD 20895-1834
(845) 546-4216
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-42871
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103K00000X
—
MD
Enumeration date
08/31/2020
Last updated
08/31/2020
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