Healthcare Provider Details

I. General information

NPI: 1992574503
Provider Name (Legal Business Name): MONARCH BEHAVIOR ANALYSIS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2023
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6261 W ATLANTIC BLVD
MARGATE FL
33063-5128
US

IV. Provider business mailing address

6261 W ATLANTIC BLVD
MARGATE FL
33063-5128
US

V. Phone/Fax

Practice location:
  • Phone: 617-470-9827
  • Fax: 561-816-4315
Mailing address:
  • Phone: 561-900-5504
  • Fax: 561-816-4315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BEATRIZ ELIZABETH KOURACLES
Title or Position: MANAGER
Credential:
Phone: 617-470-9827