Athena Behavior Analysis, Llc | |
1230 Fargo Dr Melbourne FL 32940-6901 | |
(424) 302-3643 | |
Not Available |
Full Name | Athena Behavior Analysis, Llc |
---|---|
Speciality | Behavior Analyst |
Location | 1230 Fargo Dr, Melbourne, Florida |
Authorized Official Name and Position | Maureen Gamache (OWNER) |
Authorized Official Contact | 4243023643 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Athena Behavior Analysis, Llc 1230 Fargo Dr Melbourne FL 32940-6901 Ph: (424) 302-3643 | Athena Behavior Analysis, Llc 1230 Fargo Dr Melbourne FL 32940-6901 Ph: (424) 302-3643 |
NPI Number | 1629687686 |
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Provider Enumeration Date | 07/27/2020 |
Last Update Date | 11/27/2023 |
Certification Date | 07/27/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629687686 | NPI | - | NPPES |
105117700 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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