Provider Demographics
NPI:1306455043
Name:MALACH, TAYLOR CHRISTINE MONKEN (MABA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:CHRISTINE MONKEN
Last Name:MALACH
Suffix:
Gender:F
Credentials:MABA, BCBA, LBA
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:CHRISTINE
Other - Last Name:MONKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MABA, BCBA, LBA
Mailing Address - Street 1:6712 FLOWERVALE DR
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-1708
Mailing Address - Country:US
Mailing Address - Phone:618-334-8713
Mailing Address - Fax:
Practice Address - Street 1:601 S NEW BALLAS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8221
Practice Address - Country:US
Practice Address - Phone:314-251-6933
Practice Address - Fax:314-251-8973
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022026434103K00000X, 103K00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program