Provider Demographics
NPI:1710739271
Name:SEARS, MELANIE DYANA (BCBA)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:DYANA
Last Name:SEARS
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 1:4697 COUNTY ROAD 3
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:OH
Mailing Address - Zip Code:43558-9047
Mailing Address - Country:US
Mailing Address - Phone:419-704-7124
Mailing Address - Fax:
Practice Address - Street 1:12660 ARCHBOLD WHITEHOUSE RD
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:OH
Practice Address - Zip Code:43571-9566
Practice Address - Country:US
Practice Address - Phone:419-875-6986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-24-72085103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst