Provider Demographics
NPI:1295235448
Name:UTZ, MELISSA MARIA (BCBA)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MARIA
Last Name:UTZ
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 1:1474 E LEBANON RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-5833
Mailing Address - Country:US
Mailing Address - Phone:302-244-3404
Mailing Address - Fax:855-596-2438
Practice Address - Street 1:1474 E LEBANON RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-5833
Practice Address - Country:US
Practice Address - Phone:302-244-3404
Practice Address - Fax:855-596-2438
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-14
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst