Provider Demographics
NPI:1871151639
Name:BALZA, MELANY (RBT)
Entity type:Individual
Prefix:
First Name:MELANY
Middle Name:
Last Name:BALZA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:MELANY
Other - Middle Name:ANDREA
Other - Last Name:BALZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8900 SW 117TH AVE STE B201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-2184
Mailing Address - Country:US
Mailing Address - Phone:305-896-0425
Mailing Address - Fax:
Practice Address - Street 1:8900 SW 117TH AVE STE B201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-2184
Practice Address - Country:US
Practice Address - Phone:305-896-0425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-05
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-23-65945103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst