Individual
MELISSA THEODORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
JD., M.ED, BCBA
Contact information
Practice address
833 S KENWOOD AVE, BALTIMORE, MD 21224-3839
(508) 667-5966
Mailing address
833 S KENWOOD AVE, BALTIMORE, MD 21224-3839
(508) 667-5966
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/27/2019
Last updated
03/27/2019
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