Healthcare Provider Details

I. General information

NPI: 1881256865
Provider Name (Legal Business Name): MEREDITH A LEE BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4855 W HILLSBORO BLVD STE B12
COCONUT CREEK FL
33073-4365
US

IV. Provider business mailing address

4855 W HILLSBORO BLVD STE B12
COCONUT CREEK FL
33073-4365
US

V. Phone/Fax

Practice location:
  • Phone: 754-399-8507
  • Fax:
Mailing address:
  • Phone: 754-399-8507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-78287
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: