Provider Demographics
NPI:1831750074
Name:EARLY, MELISSA E (RBT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:E
Last Name:EARLY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 NORTHERN WAY APT 304
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-3876
Mailing Address - Country:US
Mailing Address - Phone:850-797-4106
Mailing Address - Fax:
Practice Address - Street 1:600 NORTHERN WAY APT 304
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-3876
Practice Address - Country:US
Practice Address - Phone:850-797-4106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst