MEDICARE: THERAPEUTICS WITH MELISSA KNOPP LLC

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

General Provider Information

NPI Number	:	1962019018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPEUTICS WITH MELISSA KNOPP LLC

Provider Business Mailing Address
First Line	:	3917 N MERIDIAN AVE APT 102
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3828
Country	:	US
Telephone Number	:	201-819-1499
Fax Number	:

Provider Business Practice Location Address
First Line	:	3917 N MERIDIAN AVE APT 102
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3828
Country	:	US
Telephone Number	:	201-819-1499
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MELISSA DANIELLE KNOPP
Credential	:	M.S.
Telephone Number	:	201-819-1499

Provider Enumeration Date	:	09/23/2020
Last Update Date	:	09/23/2020

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