Provider Demographics
NPI:1952977688
Name:ARGIROS, MARANDA JEAN
Entity type:Individual
Prefix:
First Name:MARANDA
Middle Name:JEAN
Last Name:ARGIROS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3430 S ASCAINO AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-4854
Mailing Address - Country:US
Mailing Address - Phone:307-421-6296
Mailing Address - Fax:
Practice Address - Street 1:3430 S ASCAINO AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-4854
Practice Address - Country:US
Practice Address - Phone:307-421-6296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
ID1-21-56252103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician