Doctor Name: | MRS. MELISSA STOYKO |
NPI Number: | 1043649775 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | B.S.W |
License Number: | |
Business Practice Address: | 3010 Grand Ave Children And Adolescent Behavioral Services Waukegan, IL - 600852321 |
Business Phone Number: | 8473778953 |
Business Fax Number: | |
Mailing Address: | 3010 Grand Ave, Children And Adolescent Behavioral Services WAUKEGAN |
State: | IL |
Postal Code: | 600852321 |
Phone Number: | 8473778953 |
Fax Number: | |
NPI Enumeration Date: | 11/04/2013 |
NPI Last Update Date: | 11/04/2013 |
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: |