Individual
MELISSA A DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
9810 BLUEGRASS PKWY, LOUISVILLE, KY 40299-1906
(502) 259-8821
(502) 259-8821
Mailing address
153 PLANTATION DR, SHELBYVILLE, KY 40065-8310
(502) 259-8821
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-12-11464
—
Other
Enumeration date
06/07/2007
Last updated
03/17/2018
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