Mirinda Marie Detloff, is a
Behavior Technician based in Dallas, Texas. Mirinda Marie Detloff is licensed to practice in * (Not Available) (license number ) and her current practice location is
6803 Hillcrest Ave, Dallas, Texas. She can be reached at her office (for appointments etc.) via phone at
(855) 223-7123.
NPI number for Mirinda Marie Detloff is 1306336532 and her current mailing address is 16782 Von Karman Ave Ste 11, Irvine, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1306336532.
Healthcare Provider's Profile
| Full Name | Mirinda Marie Detloff |
|---|
| Gender | Female |
|---|
| Speciality | Behavior Technician |
|---|
| Location | 6803 Hillcrest Ave, Dallas, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1306336532
- Provider Enumeration Date: 05/14/2018
- Last Update Date: 07/06/2021
Medical Identifiers
Medical identifiers for Mirinda Marie Detloff such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306336532 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mirinda Marie Detloff is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mirinda Marie Detloff,
16782 Von Karman Ave Ste 11,
Irvine, CA 92606-2417
Ph: (855) 223-7123 | Mirinda Marie Detloff,
6803 Hillcrest Ave,
Dallas, TX 75205-1308
Ph: (855) 223-7123 |
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