Provider Demographics
NPI:1710257373
Name:FERRONE, MELISSA LIVERMORE (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:LIVERMORE
Last Name:FERRONE
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 1:9818 ZACKERY AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2124
Mailing Address - Country:US
Mailing Address - Phone:910-352-7836
Mailing Address - Fax:
Practice Address - Street 1:9818 ZACKERY AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2124
Practice Address - Country:US
Practice Address - Phone:910-352-7836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-11-9446103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst