Provider Demographics
NPI:1952755290
Name:SHAW, MELINDA (BCBA)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:SHAW
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 1:9150 ESTATE THOMAS
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ST. THOMAS
Mailing Address - State:U.S. VIRGIN ISLANDS
Mailing Address - Zip Code:00802
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9150 ESTATE THOMAS
Practice Address - Street 2:SUITE 202
Practice Address - City:ST. THOMAS
Practice Address - State:U.S. VIRGIN ISLANDS
Practice Address - Zip Code:00802
Practice Address - Country:UM
Practice Address - Phone:340-719-7007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-22
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst