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NPI Code Detail

MEDICARE: MELISSA COYLE

MEDICARE: MELISSA COYLE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-17-27637CA

General Provider Information

NPI Number : 1093223943
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA COYLE
Provider Business Mailing Address
First Line : 640 N TUSTIN AVE STE 101
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-3731
Country : US
Telephone Number : 949-608-3697
Fax Number : 949-606-7089
Provider Business Practice Location Address
First Line : 640 N TUSTIN AVE STE 101
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-3731
Country : US
Telephone Number : 949-608-3697
Fax Number : 949-606-7089
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2018
Last Update Date : 01/12/2018

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Directions to “ MELISSA COYLE ” Practice Location

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