Organization
ATHENA BEHAVIOR ANALYSIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAUREEN GAMACHE BCBA (OWNER)
(424) 302-3643
Entity
Organization
Contact information
Practice address
1230 FARGO DR, MELBOURNE, FL 32940-6901
(424) 302-3643
Mailing address
1230 FARGO DR, MELBOURNE, FL 32940-6901
(424) 302-3643
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105117700
—
FL
Enumeration date
07/27/2020
Last updated
11/27/2023
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