Healthcare Provider Details

I. General information

NPI: 1356924542
Provider Name (Legal Business Name): MELISSA ACHESON MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 RITTENHOUSE PL
ARDMORE PA
19003-2209
US

IV. Provider business mailing address

424 CONARROE ST FL 1
PHILADELPHIA PA
19128-3406
US

V. Phone/Fax

Practice location:
  • Phone: 860-418-7796
  • Fax:
Mailing address:
  • Phone: 860-418-7796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number16401
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: