Healthcare Provider Details

I. General information

NPI: 1417355934
Provider Name (Legal Business Name): MELISSA K STEELE-PARKS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2014
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 HAMMOND DR BLDG 16-100
ATLANTA GA
30328-6144
US

IV. Provider business mailing address

750 HAMMOND DR BLDG 16-100
ATLANTA GA
30328-6144
US

V. Phone/Fax

Practice location:
  • Phone: 678-974-2162
  • Fax: 888-533-9896
Mailing address:
  • Phone: 678-974-2162
  • Fax: 888-533-9896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-9982
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: