| Doctor Name: | MELISSA GARDNER |
| NPI Number: | 1275746174 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 34004564 |
| Business Practice Address: | 1000 Lonetree Road Linton, IN - 474410553 |
| Business Phone Number: | 8128474435 |
| Business Fax Number: | 8128478297 |
| Mailing Address: | Po Box 4323, 620 8th Avenue TERRE HAUTE |
| State: | IN |
| Postal Code: | 478040323 |
| Phone Number: | 8122318323 |
| Fax Number: | 8122318400 |
| NPI Enumeration Date: | 05/07/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 34004564 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |