Provider Demographics
NPI:1306976105
Name:MERANDA, ANGELA DAWN (BS, MA, BCBA)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:DAWN
Last Name:MERANDA
Suffix:
Gender:F
Credentials:BS, MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:3830 SOUTH COUNTY ROAD 101 EAST
Mailing Address - City:CLAYTON
Mailing Address - State:IN
Mailing Address - Zip Code:46118-0360
Mailing Address - Country:US
Mailing Address - Phone:317-539-7536
Mailing Address - Fax:317-539-4673
Practice Address - Street 1:3830 S COUNTY ROAD 101 E
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:IN
Practice Address - Zip Code:46118-9663
Practice Address - Country:US
Practice Address - Phone:317-539-7536
Practice Address - Fax:317-539-4673
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst