Provider Demographics
NPI:1366100992
Name:HANNA, MELISSA HOBSON (BCBA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:HOBSON
Last Name:HANNA
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 1:393 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:WEST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02379-1623
Mailing Address - Country:US
Mailing Address - Phone:781-290-3886
Mailing Address - Fax:
Practice Address - Street 1:179 HIGHLAND AVE # 1037
Practice Address - Street 2:
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-5828
Practice Address - Country:US
Practice Address - Phone:929-222-8148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-01
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3739103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty