Provider Demographics
NPI:1841784626
Name:PRICKETT, MELANIE MERCEDES (RBT)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:MERCEDES
Last Name:PRICKETT
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:MERCEDES
Other - Last Name:PRIDDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9153 W 133RD ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-4333
Mailing Address - Country:US
Mailing Address - Phone:913-257-5185
Mailing Address - Fax:833-340-7117
Practice Address - Street 1:9153 W 133RD ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-4333
Practice Address - Country:US
Practice Address - Phone:913-257-5185
Practice Address - Fax:833-340-7117
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician