Provider Demographics
NPI:1831885714
Name:COBB-MILLER, MELODIE (BCBA LBA)
Entity type:Individual
Prefix:MS
First Name:MELODIE
Middle Name:
Last Name:COBB-MILLER
Suffix:
Gender:F
Credentials:BCBA LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-5600
Mailing Address - Country:US
Mailing Address - Phone:540-398-0017
Mailing Address - Fax:
Practice Address - Street 1:1106 REVOLUTION ST
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-3721
Practice Address - Country:US
Practice Address - Phone:443-206-8669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLBA2339103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst