Provider Demographics
NPI:1699286161
Name:NAUCK, MEGHAN NICOLE (BCBA)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:NICOLE
Last Name:NAUCK
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 1:1711 E CENTRAL TEXAS EXPY STE 302
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-9147
Mailing Address - Country:US
Mailing Address - Phone:678-467-8484
Mailing Address - Fax:
Practice Address - Street 1:3106 S W S YOUNG DR STE 105
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-2007
Practice Address - Country:US
Practice Address - Phone:678-467-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-17-28480103K00000X
TX8737106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst