Provider Demographics
NPI:1568603629
Name:YONCHUK, MELISSA CARUTH (M ED, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:CARUTH
Last Name:YONCHUK
Suffix:
Gender:F
Credentials:M ED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 WINDSOR PL
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-3925
Mailing Address - Country:US
Mailing Address - Phone:484-213-2028
Mailing Address - Fax:
Practice Address - Street 1:58 WINDSOR PL
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3925
Practice Address - Country:US
Practice Address - Phone:484-213-2028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst