Healthcare Provider Details

I. General information

NPI: 1235067117
Provider Name (Legal Business Name): MELISSA SHANNEN OGBURN MS, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1256 MARLKRESS RD
CHERRY HILL NJ
08003-2626
US

IV. Provider business mailing address

37 E ASHLAND AVE
PLEASANTVILLE NJ
08232-3501
US

V. Phone/Fax

Practice location:
  • Phone: 856-888-6968
  • Fax:
Mailing address:
  • Phone: 856-888-6968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number15BC00362300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: