Melissa Ann Anderson
Individual provider Active NPI Behavior Technician · Bountiful, UT
NPI 1063934099 · NPPES record last updated Jul 11, 2017
Key facts
- NPI
- 1063934099
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 415 Medical Dr Ste D101
Bountiful, UT 84010-8905 - Phone
- (201) 683-1062
- NPI assigned
- Jul 11, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurobehavioral Center for Growth LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
415 Medical Dr Ste D101
Bountiful, UT 84010-8905
Mailing address
415 Medical Dr Ste D101
Bountiful, UT 84010-8905
Other providers in Bountiful, UT
- Alyssa Anderson
- Brooke Anderson
- Carey Marie Anderson
- Holly Marie Anderson
- Jeffrey Anderson
- Nicolas Anderson
- Ryan K Anderson
- Stephen Karl Anderson
- Andrea D Hanson Lcmhc PLLC
- Rebecca P Andrews
All providers in Bountiful, UT · Behavior Technician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.