MEDICARE: MELISSA HOLGUIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1417889890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA HOLGUIN

Provider Business Mailing Address
First Line	:	PO BOX 96407
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85072-6407
Country	:	US
Telephone Number	:	888-611-0870
Fax Number	:

Provider Business Practice Location Address
First Line	:	11153 WESTWOOD LOOP # 11145
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-6533
Country	:	US
Telephone Number	:	888-611-0870
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ MELISSA HOLGUIN ” Practice Location

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