Provider Demographics
NPI:1386049377
Name:DALKE, MEAGAN (MA, BCBA)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:DALKE
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5236 SE 115TH PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:34420-3929
Mailing Address - Country:US
Mailing Address - Phone:352-286-8561
Mailing Address - Fax:
Practice Address - Street 1:3001 W SILVER SPRINGS BLVD BLDG 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34475-5647
Practice Address - Country:US
Practice Address - Phone:352-358-3700
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2014-11-03
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-19-39287103K00000X, 103K00000X
247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-19-39287OtherBEHAVIOR ANALYSIS CERTIFICATION BOARD