Provider Demographics
NPI:1568610590
Name:ROBERTS, MELISSA BIAFORE (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:BIAFORE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:BIAFORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 HUXLEY RD STE 102
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3188
Mailing Address - Country:US
Mailing Address - Phone:865-399-8885
Mailing Address - Fax:
Practice Address - Street 1:120 HUXLEY RD STE 102
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3188
Practice Address - Country:US
Practice Address - Phone:865-399-5888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-15-05398106S00000X
TNLBA0000000484103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician