Doctor Name: | MELISSA CRAIG |
NPI Number: | 1093190183 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1817 Gravois Rd High Ridge, MO - 630492668 |
Business Phone Number: | 6363760079 |
Business Fax Number: | 6366778440 |
Mailing Address: | 227 E Main St, FESTUS |
State: | MO |
Postal Code: | 630281952 |
Phone Number: | 6369312700 |
Fax Number: | 6369315304 |
NPI Enumeration Date: | 07/30/2015 |
NPI Last Update Date: | 07/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |