Doctor Name: | MELISSA GINEST |
NPI Number: | 1003276734 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | B.A. |
License Number: | |
Business Practice Address: | 608 Road 11 Powell, WY - 824359719 |
Business Phone Number: | 3072712337 |
Business Fax Number: | |
Mailing Address: | 608 Road 11, POWELL |
State: | WY |
Postal Code: | 824359719 |
Phone Number: | 3072712337 |
Fax Number: | |
NPI Enumeration Date: | 02/23/2016 |
NPI Last Update Date: | 02/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |