Doctor Name: | JULIE MELLOW |
NPI Number: | 1093127938 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | LH 60626167 |
Business Practice Address: | 979 Tucker Rd Hood River, OR - 970319591 |
Business Phone Number: | 5414902999 |
Business Fax Number: | |
Mailing Address: | 3372 Bradley Dr, HOOD RIVER |
State: | OR |
Postal Code: | 970319614 |
Phone Number: | 5414902999 |
Fax Number: | |
NPI Enumeration Date: | 05/27/2014 |
NPI Last Update Date: | 05/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LH 60626167 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |