Provider Demographics
NPI:1760947923
Name:SELLERS, MEGAN L'HEUREUX (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:L'HEUREUX
Last Name:SELLERS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 N 124TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-1837
Mailing Address - Country:US
Mailing Address - Phone:414-763-2341
Mailing Address - Fax:
Practice Address - Street 1:4125 N 124TH ST
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-1837
Practice Address - Country:US
Practice Address - Phone:414-763-2341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI277-140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst