Provider Demographics
NPI:1225336977
Name:GOHL, MELISSA (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:GOHL
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9357 GENERAL DR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4662
Mailing Address - Country:US
Mailing Address - Phone:734-834-9394
Mailing Address - Fax:
Practice Address - Street 1:9357 GENERAL DR
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4662
Practice Address - Country:US
Practice Address - Phone:734-834-9394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst