Healthcare Provider Details

I. General information

NPI: 1306455043
Provider Name (Legal Business Name): TAYLOR CHRISTINE MONKEN MALACH MABA, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAYLOR CHRISTINE MONKEN MABA, BCBA, LBA

II. Dates (important events)

Enumeration Date: 07/29/2020
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 ELBRIDGE PAYNE RD STE 1300
CHESTERFIELD MO
63017-8538
US

IV. Provider business mailing address

6712 FLOWERVALE DR
HAZELWOOD MO
63042-1708
US

V. Phone/Fax

Practice location:
  • Phone: 636-898-2080
  • Fax: 636-898-2082
Mailing address:
  • Phone: 618-334-8713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2022026434
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: