Provider Demographics
NPI:1669978185
Name:EHN, MONICA (BCBA)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:EHN
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 1:2580 1ST AVE S APT 110
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:IA
Mailing Address - Zip Code:50009-1731
Mailing Address - Country:US
Mailing Address - Phone:641-204-9605
Mailing Address - Fax:
Practice Address - Street 1:1860 NW 118TH ST STE 100
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8278
Practice Address - Country:US
Practice Address - Phone:888-228-8476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1-18-29342103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst