MEDICARE: MS. SID' TORIA AJ MELTON

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
1	103K00000X	Behavior Analyst		AL

General Provider Information

NPI Number	:	1255257200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SID' TORIA AJ MELTON

Provider Business Mailing Address
First Line	:	1444 18TH WAY SW
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35211-4730
Country	:	US
Telephone Number	:	205-276-8231
Fax Number	:

Provider Business Practice Location Address
First Line	:	1444 18TH WAY SW
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35211-4730
Country	:	US
Telephone Number	:	205-276-8231
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2026
Last Update Date	:	06/25/2026

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