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Individual
MELISSA KATHRYN PUCKETT
Active
Individual
MELISSA KATHRYN PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-202457
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113412600
—
FL
Enumeration date
11/01/2021
Last updated
09/08/2022
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