| Doctor Name: | MELISSA A DOUGLAS |
| NPI Number: | 1043515141 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW-CC |
| License Number: | MC12568 |
| Business Practice Address: | 375 Main St Rockland, ME - 048413304 |
| Business Phone Number: | 2075960359 |
| Business Fax Number: | 2075960350 |
| Mailing Address: | 375 Main St, ROCKLAND |
| State: | ME |
| Postal Code: | 048413304 |
| Phone Number: | 2075960359 |
| Fax Number: | 2075960350 |
| NPI Enumeration Date: | 01/20/2011 |
| NPI Last Update Date: | 01/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | MC12568 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |