Provider Demographics
NPI:1497095566
Name:MONICA GOTREAU BCBA LLC
Entity Type:Organization
Organization Name:MONICA GOTREAU BCBA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GOTREAU
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:714-210-9411
Mailing Address - Street 1:92-1126 OLANI ST APT 1
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-4227
Mailing Address - Country:US
Mailing Address - Phone:714-210-9411
Mailing Address - Fax:
Practice Address - Street 1:92-1126 OLANI ST APT 1
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-4227
Practice Address - Country:US
Practice Address - Phone:714-210-9411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty