Provider Demographics
NPI:1831875699
Name:NEFF, MIRANDA GRACE JINXIA (RBT)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:GRACE JINXIA
Last Name:NEFF
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1260 WEATHERFORD HWY
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-4822
Mailing Address - Country:US
Mailing Address - Phone:682-333-1555
Mailing Address - Fax:817-717-2378
Practice Address - Street 1:1260 WEATHERFORD HWY
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-4822
Practice Address - Country:US
Practice Address - Phone:682-333-1555
Practice Address - Fax:817-717-2378
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-23-279734106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician