MEDICARE: MELISSA KASPER YARBROUGH BCBA

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	103K00000X	Behavior Analyst	1-12-11470

General Provider Information

NPI Number	:	1558656041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA KASPER YARBROUGH BCBA

Provider Business Mailing Address
First Line	:	4620 N STATE ROAD 7
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5884
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2895 HUELAND POND BLVD
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-7667
Country	:	US
Telephone Number	:	888-754-0398
Fax Number	:

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

Provider Enumeration Date	:	06/13/2011
Last Update Date	:	11/21/2025

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