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NPI Code Detail

MEDICARE: STACEY MONIQUE DELAROSA M.ED., BCBA, LBA

MEDICARE: STACEY MONIQUE DELAROSA M.ED., BCBA, LBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst11829680TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285906438
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY MONIQUE DELAROSA M.ED., BCBA, LBA
Provider Business Mailing Address
First Line : 1301 CENTRAL EXPY S STE 230
Second Line :
City : ALLEN
State : TX
Zip : 75013-8122
Country : US
Telephone Number : 855-772-8847
Fax Number : 248-912-1566
Provider Business Practice Location Address
First Line : 1301 CENTRAL EXPY S STE 230
Second Line :
City : ALLEN
State : TX
Zip : 75013-8122
Country : US
Telephone Number : 855-772-8847
Fax Number : 248-912-1566
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2012
Last Update Date : 05/21/2024

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