Individual
MELISSA REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
195 W SCHROCK RD, WESTERVILLE, OH 43081-2890
(614) 355-7570
(614) 355-7580
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
COBA.01132
OH
106S00000X
Behavior Technician
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473276
—
OH
Enumeration date
09/06/2018
Last updated
01/05/2023
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