Individual
MELAKU ANTOINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
528 ELM AVE, UPPER DARBY, PA 19082-2125
(267) 243-0597
Mailing address
528 ELM AVE, UPPER DARBY, PA 19082-2125
(267) 243-0597
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH004708
PA
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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