Provider Demographics
NPI:1548548464
Name:HOWARD, MONICA ROSE (BCBA)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:ROSE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 S 19TH ST
Mailing Address - Street 2:APT 4
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-3136
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:626 S 19TH ST
Practice Address - Street 2:APT 4
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-3136
Practice Address - Country:US
Practice Address - Phone:631-291-1988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-09-6567103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst