Provider Demographics
NPI:1073339263
Name:ARCHER, MAUREEN (MED, BCBA, LBS)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:ARCHER
Suffix:
Gender:F
Credentials:MED, BCBA, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 RANDY LN
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-4753
Mailing Address - Country:US
Mailing Address - Phone:412-913-0282
Mailing Address - Fax:
Practice Address - Street 1:2644 BANKSVILLE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15216-2812
Practice Address - Country:US
Practice Address - Phone:412-913-0282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH007433103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst