Individual
MELANIE BALSAMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2808 KILPATRICK BLVD, MONROE, LA 71201-5139
(318) 245-4113
(318) 588-8909
Mailing address
PO BOX 1823, WEST MONROE, LA 71294-1823
(318) 588-8908
(318) 588-8909
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
C-130
LA
106S00000X
Behavior Technician
R-1985
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-22-14074
BACB
—
01
—
RBT-17-40016
BACB
—
Enumeration date
11/18/2022
Last updated
01/03/2023
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