Provider Demographics
NPI:1417545427
Name:CHARRON, MELISSA MAY MARSH (MED, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MAY MARSH
Last Name:CHARRON
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 BOULEVARD E APT 4C
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-5974
Mailing Address - Country:US
Mailing Address - Phone:760-707-4595
Mailing Address - Fax:
Practice Address - Street 1:7300 BOULEVARD E APT 4C
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-5974
Practice Address - Country:US
Practice Address - Phone:760-707-4595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2023-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician