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General NPI Number Information
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NPI Number | 1902569205
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Entity Type | Individual
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Provider Name | MELANIE E PARKS BHT
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Gender | Female
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Dates
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Enumeration Date | 10/14/2021
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 9601 BUSTLETON AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19115-3810
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Country | US
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Telephone | 856-346-0005
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Fax |
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Provider Business Mailing Address
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Address Line | 9601 BUSTLETON AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19115-3810
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Country | US
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Telephone | 856-346-0005
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BH005855
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License Number State | PA
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