Healthcare Provider Details

I. General information

NPI: 1841657475
Provider Name (Legal Business Name): ELENA LABISSIERE BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2016
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 W PALMETTO PARK RD
BOCA RATON FL
33433-3424
US

IV. Provider business mailing address

560 VILLAGE BLVD STE 100
WEST PALM BEACH FL
33409-1963
US

V. Phone/Fax

Practice location:
  • Phone: 561-335-5681
  • Fax:
Mailing address:
  • Phone: 561-335-5681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-15-21310
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: