Individual
IAN MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
2012 IRONWOOD CIRCLE, SUITE 100, SOUTH BEND, IN 46635-1889
(855) 324-0885
(765) 450-6664
Mailing address
700 E FIRMIN STREET, SUITE 209, KOKOMO, IN 46902-2375
(765) 454-9748
(765) 450-6664
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-14-10035
MA
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-14-10035
BCBA CERTIFICATE
—
Enumeration date
10/14/2014
Last updated
12/01/2015
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