Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-11-8925 |
NPI | 1003104720 |
---|---|
Provider Name | Ms. Melissa Ann Marsh |
First Address | Hewitt, TX 76643-3990 |
Second Address | Hewitt, TX 76643-3990 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2011 |
Last Update Date | 15/07/2011 |