| Doctor Name: | ROBERT A MELLIN |
| NPI Number: | 1043294333 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M ED LPC CSW CACII |
| License Number: | 6401004397 |
| Business Practice Address: | 580 W College Ave Marquette, MI - 498552705 |
| Business Phone Number: | 9062253985 |
| Business Fax Number: | 9062254562 |
| Mailing Address: | Po Box 220, MARQUETTE |
| State: | MI |
| Postal Code: | 498550220 |
| Phone Number: | 9062254821 |
| Fax Number: | 9062254537 |
| NPI Enumeration Date: | 12/01/2005 |
| NPI Last Update Date: | 02/26/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 6401004397 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |