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General NPI Number Information
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NPI Number | 1265759658
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Entity Type | Individual
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Provider Name | MELISSA HALE PHD, BCBA-D
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Gender | Female
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Dates
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Enumeration Date | 04/26/2010
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Last Update Date | 04/26/2010
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Provider Practice Location Address
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Address Line | 5665 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33146-2510
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Country | US
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Telephone | 305-284-2350
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Fax | 305-284-6555
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Provider Business Mailing Address
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Address Line | 5665 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33146-2510
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Country | US
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Telephone | 305-284-2350
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Fax | 305-284-6555
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-02-0784
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY7272
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License Number State | FL
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