Provider Demographics
NPI:1164298550
Name:HAMMEL, MELANIE JEAN (BCBA)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:JEAN
Last Name:HAMMEL
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 1:14733 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2660
Mailing Address - Country:US
Mailing Address - Phone:314-339-7732
Mailing Address - Fax:314-778-9286
Practice Address - Street 1:14733 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-2660
Practice Address - Country:US
Practice Address - Phone:314-339-7732
Practice Address - Fax:314-778-9286
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021040581103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst