MEDICARE: MELISSA ANN HAACK RBT

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	106S00000X	Behavior Technician	BACB1467018	WV

General Provider Information

NPI Number	:	1942157680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ANN HAACK RBT

Provider Business Mailing Address
First Line	:	48 SNOWDROP CT
Second Line	:
City	:	KEARNEYSVILLE
State	:	WV
Zip	:	25430-7701
Country	:	US
Telephone Number	:	681-258-0656
Fax Number	:

Provider Business Practice Location Address
First Line	:	231 COBBLE STONE DR
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22602-6871
Country	:	US
Telephone Number	:	571-919-5719
Fax Number	:

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

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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Directions to “ MELISSA ANN HAACK RBT” Practice Location

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