| Doctor Name: | MRS. MELISSA LYNN FERNALD |
| NPI Number: | 1598070591 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LICSW, MLADC |
| License Number: | 0816 |
| Business Practice Address: | 35 Center St Wolfeboro, NH - 038944324 |
| Business Phone Number: | 6035695818 |
| Business Fax Number: | 8889758097 |
| Mailing Address: | Po Box 1464, WOLFEBORO |
| State: | NH |
| Postal Code: | 038941464 |
| Phone Number: | 6035694134 |
| Fax Number: | 6035694137 |
| NPI Enumeration Date: | 08/13/2010 |
| NPI Last Update Date: | 05/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 0816 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |