Most Relevant Information
Provider Data
| NPI Number: | 1003491804 |
| Provider Name: | ANGELA TERESE MELLONE BCBA |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: | 12147894 |
Most Important Dates
| Enumeration Date: | 03/12/2021 |
| Last Updated: | 04/23/2021 |
Provider Practice Location
125 HALF MILE RD STE 200
RED BANK
NJ
077016749
Practice Location Phone/Fax
| Phone: | 8558326727 |
| Fax: | 7726759100 |
Provider Mailing Location
107 NORTHRUP DR
BRICK
NJ
087242021
Provider Mailing Phone/Fax
| Phone: | 7323200940 |
| Fax: |