Healthcare Provider Details

I. General information

NPI: 1457835522
Provider Name (Legal Business Name): MELISSA GUZEK BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2018
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 TREMONT ST STE 31
DUXBURY MA
02332-5315
US

IV. Provider business mailing address

593 COUNTRY WAY
SCITUATE MA
02066-2009
US

V. Phone/Fax

Practice location:
  • Phone: 339-499-8464
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-31900
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: