Provider Demographics
NPI:1114152907
Name:SIGEL, MELISSA ANNE (LPE, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANNE
Last Name:SIGEL
Suffix:
Gender:F
Credentials:LPE, BCBA
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:ANNE
Other - Last Name:AINSLIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPE, BCBA
Mailing Address - Street 1:11 CHILDREN'S WAY
Mailing Address - Street 2:#654
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202
Mailing Address - Country:US
Mailing Address - Phone:501-364-5150
Mailing Address - Fax:501-364-1592
Practice Address - Street 1:11 CHILDREN'S WAY
Practice Address - Street 2:#654
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212
Practice Address - Country:US
Practice Address - Phone:501-364-5150
Practice Address - Fax:501-364-5150
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1-09-5750103K00000X
AR10-04E101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst