Provider Demographics
NPI:1295254530
Name:JUHAN, MELANIE SCOT HART (MED, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:SCOT HART
Last Name:JUHAN
Suffix:
Gender:F
Credentials:MED, BCBA, LBA
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:SCOT
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, BCBA, LBA
Mailing Address - Street 1:943 GLENWOOD STATION LN STE 201
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-5714
Mailing Address - Country:US
Mailing Address - Phone:434-923-8252
Mailing Address - Fax:
Practice Address - Street 1:3500 REMSON CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-3508
Practice Address - Country:US
Practice Address - Phone:434-923-8252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-14-17040103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst