Healthcare Provider Details

I. General information

NPI: 1366845158
Provider Name (Legal Business Name): MELISSA S PARISH M.S., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2014
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26121 US ROUTE 11 STE 1
EVANS MILLS NY
13637-3283
US

IV. Provider business mailing address

PO BOX 253
SKILLMAN NJ
08558-0253
US

V. Phone/Fax

Practice location:
  • Phone: 315-221-5101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-9818
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: