Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MELISSA SOUTHALL BROOME, BCBA
ActiveBehavior Analyst · VICKSBURG, MS
Registration Details
- NPI Number
- 1053969097
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 3, 2019 (6.6318853677934 yrs)
- Last Updated
- Jan 24, 2022
- License
-
220005 (MS)
Practice Information
- Address
-
2222 S FRONTAGE RDVICKSBURG, MS, 391805271Browse MS providers · Browse ZIP 39180
- Phone
- 6018523271
- Primary Specialty
-
Behavior Analyst
103K00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.