Provider Demographics
NPI:1811424831
Name:BRIGHTBILL, MELISA MARIE (BCBA)
Entity Type:Individual
Prefix:
First Name:MELISA
Middle Name:MARIE
Last Name:BRIGHTBILL
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 1:23 PALMER ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-9734
Mailing Address - Country:US
Mailing Address - Phone:717-270-0949
Mailing Address - Fax:
Practice Address - Street 1:23 PALMER ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-9734
Practice Address - Country:US
Practice Address - Phone:717-270-0949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-12-11548103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst