Provider Demographics
NPI:1003198573
Name:INTIHAR, MAUREEN (BCBA)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:INTIHAR
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:
Other - Last Name:HOEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10567 CROOKED STICK DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-8501
Mailing Address - Country:US
Mailing Address - Phone:614-989-4107
Mailing Address - Fax:
Practice Address - Street 1:2801 MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104-3815
Practice Address - Country:US
Practice Address - Phone:216-448-6547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOBA.00364103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty