Provider Demographics
NPI:1598288250
Name:MONDESIR, DLAUREN (BCBA)
Entity Type:Individual
Prefix:
First Name:DLAUREN
Middle Name:
Last Name:MONDESIR
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:DLAUREN
Other - Middle Name:
Other - Last Name:OXIDINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4203 SW HIGH MEADOWS AVE
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-3726
Mailing Address - Country:US
Mailing Address - Phone:772-222-5560
Mailing Address - Fax:
Practice Address - Street 1:4203 SW HIGH MEADOWS AVE
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-3726
Practice Address - Country:US
Practice Address - Phone:772-222-5560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-24
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty