Jackson, Melissa R

Jackson, Melissa R is an individual health care provider with primary practice located at 860 Melrose Ave , Bronx NY 10451-4443. She recently has only one registered license in Behavioral Health & Social Service Providers / Assistant Behavior Analyst, which is considered as her primary health care specialty. Jackson, Melissa R can be contacted via phone (914) 619-7791.

Contact Information

Primary practice address
860 Melrose Ave Bronx NY 10451-4443
Phone: (914) 619-7791
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Assistant Behavior Analyst 106E00000X

Profile Details

NPI number 1437730785
LBN Legal business name Jackson, Melissa R
Credentials LMSW
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2021
Last updated Apr 19th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437730785 NPPES
New York MEDICAID 00000

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