Healthcare Provider Details

I. General information

NPI: 1700105905
Provider Name (Legal Business Name): MICHELLE DECHEONA BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2010
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2118 SE RAYS WAY
STUART FL
34994-3999
US

IV. Provider business mailing address

3464 SE FAIRWAY OAKS TRL
STUART FL
34997-4708
US

V. Phone/Fax

Practice location:
  • Phone: 772-237-9625
  • Fax: 866-411-8299
Mailing address:
  • Phone: 772-237-9625
  • Fax: 866-411-8299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1096485
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: