Provider Demographics
NPI:1720480536
Name:COURANT-MORGAN, MIRANDA HICKS (BCBA)
Entity Type:Individual
Prefix:MS
First Name:MIRANDA
Middle Name:HICKS
Last Name:COURANT-MORGAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GILL ST
Mailing Address - Street 2:SUITE J
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-1721
Mailing Address - Country:US
Mailing Address - Phone:774-200-8236
Mailing Address - Fax:
Practice Address - Street 1:10 GILL ST
Practice Address - Street 2:SUITE J
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-1721
Practice Address - Country:US
Practice Address - Phone:774-200-8236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst