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General NPI Number Information
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NPI Number | 1376190215
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Entity Type | Individual
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Provider Name | MELISSA KERI SMALL M.S., BCBA, LABA
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Gender | Female
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Dates
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Enumeration Date | 08/26/2019
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 7 CYPRESS DR
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City | BURLINGTON
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State | MA
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Zip | 01803-4907
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Country | US
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Telephone | 781-328-0951
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Fax |
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Provider Business Mailing Address
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Address Line | 99 E DEDHAM ST APT 523
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City | BOSTON
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State | MA
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Zip | 02118-5024
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Country | US
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Telephone | 781-812-8521
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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