Healthcare Provider Details

I. General information

NPI: 1962046144
Provider Name (Legal Business Name): NICOLE REUS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2019
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11473 SW 251ST ST
HOMESTEAD FL
33032-2566
US

IV. Provider business mailing address

11473 SW 251ST ST
HOMESTEAD FL
33032-2566
US

V. Phone/Fax

Practice location:
  • Phone: 786-547-0691
  • Fax:
Mailing address:
  • Phone: 786-547-0691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: