Provider Demographics
NPI:1073065827
Name:BARRERA, MELISSA (LBA,BCBA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BARRERA
Suffix:
Gender:F
Credentials:LBA,BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 FAIRWAY DR
Mailing Address - Street 2:102
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1814
Mailing Address - Country:US
Mailing Address - Phone:188-888-0927
Mailing Address - Fax:
Practice Address - Street 1:1225 MAGAZINE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-4219
Practice Address - Country:US
Practice Address - Phone:504-899-2478
Practice Address - Fax:504-899-2416
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL-428103K00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician