Individual
MELISSA KISTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
6 DRUID LN, HAMBURG, NJ 07419-9718
(973) 600-6033
Mailing address
6 DRUID LN, HAMBURG, NJ 07419-9718
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-36423
NJ
Other
Enumeration date
12/23/2019
Last updated
12/23/2019
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