Healthcare Provider Details

I. General information

NPI: 1215819248
Provider Name (Legal Business Name): MELANIE ESPADA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 W LOOMIS RD STE 130
GREENFIELD WI
53220-4858
US

IV. Provider business mailing address

224 W 35TH ST STE 500
NEW YORK NY
10001-2538
US

V. Phone/Fax

Practice location:
  • Phone: 833-646-3222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: