Dianne De Mena Wager, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-34573 Issued in FL

Practice address

10300 SW 72ND St Ste 114
Miami, FL 33173-3038

Phone

(305) 508-5580

NPI assigned

Jan 13, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Ms. Dianne De Mena Cue Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1952847006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15745 SW 146TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331776890",
            "telephone_number": "855-832-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 SW 72ND ST STE 114",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733038",
            "telephone_number": "305-508-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGER",
        "first_name": "DIANNE",
        "middle_name": "DE MENA",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-13",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "0-16-7503",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-19-34573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANNE",
            "last_name": "DE MENA CUE",
            "prefix": "MS.",
            "credential": "BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Behavior Analyst in Miami, FL
• Providers in Miami, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.