Basham, Mandy Michelle

Basham, Mandy Michelle is an individual health care provider with primary practice located at 3048 S Clifton Ave Ste 112 , Springfield MO 65807-6045. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Assistant Behavior Analyst, Behavioral Health & Social Service Providers / Behavior Technician, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Basham, Mandy Michelle can be contacted via phone (417) 818-5784.

Contact Information

Primary practice address
3048 S Clifton Ave Ste 112 Springfield MO 65807-6045
Phone: (417) 818-5784
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Assistant Behavior Analyst 106E00000X 0-23-14446 Missouri
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X RBT-20-143411 Missouri
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 2024025674 Missouri

Profile Details

NPI number 1366045635
LBN Legal business name Basham, Mandy Michelle
Credentials BCABA
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2020
Last updated Jul 8th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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