Healthcare Provider Details

I. General information

NPI: 1467033787
Provider Name (Legal Business Name): CASSANDRA LEE MESNICK BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5111 AUTO CLUB DR
DEARBORN MI
48126-2749
US

IV. Provider business mailing address

420 TIMBERWALK CT UNIT 1214
PONTE VEDRA BEACH FL
32082-6249
US

V. Phone/Fax

Practice location:
  • Phone: 352-843-6413
  • Fax:
Mailing address:
  • Phone: 352-843-6413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: