Individual
MELISSA GRACE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
6000 E EVANS AVE STE 1-400, DENVER, CO 80222-5415
(720) 646-1365
Mailing address
6000 E EVANS AVE STE 1-400, DENVER, CO 80222-5415
(720) 646-1365
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BACB546233
CO
106S00000X
Behavior Technician
RBT-19-108477
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58474552
—
CO
Enumeration date
05/02/2022
Last updated
10/31/2022
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