Healthcare Provider Details

I. General information

NPI: 1558184242
Provider Name (Legal Business Name): MELANIE BLANKENSHIP BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2024
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16712 HUFFMEISTER RD BLDG 500
CYPRESS TX
77429-8050
US

IV. Provider business mailing address

300 INTERNATIONAL PKWY STE 200
LAKE MARY FL
32746-5028
US

V. Phone/Fax

Practice location:
  • Phone: 281-746-6037
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-26-17085
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: