| Doctor Name: | MS. COLLEEN A MELLERUP |
| NPI Number: | 1003840117 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LISW |
| License Number: | 995 |
| Business Practice Address: | 1150 5th St Suite #267 Coralville, IA - 522412932 |
| Business Phone Number: | 3193415933 |
| Business Fax Number: | |
| Mailing Address: | 1150 5th St, Suite #267 CORALVILLE |
| State: | IA |
| Postal Code: | 522412932 |
| Phone Number: | 3193415933 |
| Fax Number: | |
| NPI Enumeration Date: | 07/11/2006 |
| NPI Last Update Date: | 08/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 995 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |