Provider Demographics
NPI:1144610387
Name:CONROY, MELISSA (BCBA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:CONROY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 DAVIN DR
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-5208
Mailing Address - Country:US
Mailing Address - Phone:203-673-9491
Mailing Address - Fax:
Practice Address - Street 1:41 DAVIN DR
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-5208
Practice Address - Country:US
Practice Address - Phone:203-673-9491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst