Provider Demographics
NPI:1396180485
Name:MELBER, SARAH (BCBA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MELBER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:MELBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 CAPITAL LN
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5098
Mailing Address - Country:US
Mailing Address - Phone:732-364-7780
Mailing Address - Fax:
Practice Address - Street 1:19 CAPITAL LN
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5098
Practice Address - Country:US
Practice Address - Phone:732-364-7780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ11312952103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst