Individual
MIRANDA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
200 ELFORD CT, SPARTANBURG, SC 29306-3250
(864) 804-4895
Mailing address
200 ELFORD CT, SPARTANBURG, SC 29306-3250
(864) 804-4895
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-41378
SC
Other
Enumeration date
07/24/2018
Last updated
05/03/2023
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