Individual
MELANIE P BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2801 WOODLAND RD, ROSLYN, PA 19001-2242
(215) 285-3688
(215) 469-4987
Mailing address
PO BOX 1062, ROSLYN, PA 19001-9062
(215) 285-3688
(215) 469-4987
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-15-11617
PA
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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