Most Relevant Information
Provider Data
| NPI Number: | 1003580242 |
| Provider Name: | MELISSA ANNE DAMEWORTH AIRHART |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/02/2021 |
| Last Updated: | 08/02/2021 |
Provider Practice Location
7330 FERN AVE
SHREVEPORT
LA
711054971
Practice Location Phone/Fax
| Phone: | 3182903331 |
| Fax: |
Provider Mailing Location
7330 FERN AVE STE 1001
SHREVEPORT
LA
711054988
Provider Mailing Phone/Fax
| Phone: | 3182903331 |
| Fax: |