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General NPI Number Information
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NPI Number | 1669997011
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Entity Type | Individual
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Provider Name | MELISSA WALTON LACO M.ED., BCBA, COBA
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Gender | Female
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Dates
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Enumeration Date | 08/07/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 24865 DETROIT RD
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City | WESTLAKE
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State | OH
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Zip | 44145-2512
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Country | US
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Telephone | 440-250-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 24865 DETROIT RD
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City | WESTLAKE
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State | OH
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Zip | 44145-2512
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Country | US
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Telephone | 440-250-8800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-17-26230
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License Number State | OH
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