Provider Demographics
NPI:1730632241
Name:HEMP-GARDZINSKI, MELINDA (BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:
Last Name:HEMP-GARDZINSKI
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:MINDY
Other - Middle Name:HEMP
Other - Last Name:GARDZINSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCBA, LBA
Mailing Address - Street 1:1579 SAM SNEAD HWY
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:VA
Mailing Address - Zip Code:24445-2504
Mailing Address - Country:US
Mailing Address - Phone:540-969-6493
Mailing Address - Fax:
Practice Address - Street 1:1579 SAM SNEAD HWY
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:VA
Practice Address - Zip Code:24445-2504
Practice Address - Country:US
Practice Address - Phone:540-969-6493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-01
Last Update Date:2016-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000535103K00000X
TX1-14-10085103K00000X
WV1-14-10085103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst