Provider Demographics
NPI:1497932164
Name:ALEXANDER, MELISSA ANN (BCBA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:ALEXANDER
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 1:5901 OLD HICKORY BLVD APT 1005
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2949
Mailing Address - Country:US
Mailing Address - Phone:615-557-4405
Mailing Address - Fax:615-262-7823
Practice Address - Street 1:5901 OLD HICKORY BLVD APT 1005
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2949
Practice Address - Country:US
Practice Address - Phone:615-557-4405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-06-2676103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst