Provider Demographics
NPI:1609621473
Name:COLE, MELISSA K (ABA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:K
Last Name:COLE
Suffix:
Gender:F
Credentials:ABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8385 RUSHING RD E
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-7817
Mailing Address - Country:US
Mailing Address - Phone:225-377-4139
Mailing Address - Fax:225-377-4067
Practice Address - Street 1:8385 RUSHING RD E
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-7817
Practice Address - Country:US
Practice Address - Phone:225-377-4139
Practice Address - Fax:225-377-4067
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst