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General NPI Number Information
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NPI Number | 1477221125
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Entity Type | Individual
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Provider Name | MELISSA MOONEY M.ED, LBS
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Gender | Female
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 3230 N 3RD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-5719
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Country | US
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Telephone | 844-537-7473
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Fax |
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Provider Business Mailing Address
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Address Line | 533 N BUDD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19104-1783
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Country | US
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Telephone |
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | BH007983
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-19-93300
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License Number State | NJ
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