Healthcare Provider Details

I. General information

NPI: 1881212843
Provider Name (Legal Business Name): MEGHAN TALARICO MS. LBA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 N MAIN ST
NIXA MO
65714-8340
US

IV. Provider business mailing address

3048 S CLIFTON AVE
SPRINGFIELD MO
65807-5957
US

V. Phone/Fax

Practice location:
  • Phone: 417-708-3274
  • Fax:
Mailing address:
  • Phone: 417-818-5784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-61060
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: