Provider Demographics
NPI:1770274136
Name:SEXTON-DELISA, MELISSA (RBT, NRCPT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SEXTON-DELISA
Suffix:
Gender:F
Credentials:RBT, NRCPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3779 WHITNEY PARK LN
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3468
Mailing Address - Country:US
Mailing Address - Phone:561-512-1258
Mailing Address - Fax:
Practice Address - Street 1:931 VILLAGE BLVD STE 905
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-1804
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician