Individual
MICAELA LOUDERMELK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
913 N CAROLINA AVE, STATESVILLE, NC 28677-3414
(704) 881-3760
Mailing address
913 N CAROLINA AVE, STATESVILLE, NC 28677-3414
(704) 881-3760
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-24876
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
720282G
—
NC
Enumeration date
01/05/2017
Last updated
01/05/2017
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