Healthcare Provider Details

I. General information

NPI: 1952755290
Provider Name (Legal Business Name): MELINDA SHAW BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2016
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N. WEST STREET SUITE 1200
WILMINGTON DE
19801-1058
US

IV. Provider business mailing address

1000 N. WEST STREET SUITE 1200
WILMINGTON DE
19801-1058
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax: 477-675-9100
Mailing address:
  • Phone: 855-832-6727
  • Fax: 477-675-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: