Individual
BETH A. MEHLBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
580 N WASHINGTON ST, JANESVILLE, WI 53548-2984
(608) 756-5555
(608) 314-2442
Mailing address
580 N WASHINGTON ST, JANESVILLE, WI 53548-2984
(608) 756-5555
(608) 314-2442
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
323-140
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100067992
—
WI
Enumeration date
11/05/2019
Last updated
11/05/2019
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