Individual
JAMES MELLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RBT-19-80249
Contact information
Practice address
5 REVERE DR STE 120, NORTHBROOK, IL 60062-8005
(269) 929-8381
Mailing address
5 REVERE DR STE 120, NORTHBROOK, IL 60062-8005
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
19-80249
MI
Other
Enumeration date
03/10/2019
Last updated
03/10/2019
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