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NPI Code Detail

MEDICARE: MELISSA WALLAIN LPC

MEDICARE:   MELISSA  WALLAIN  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor12398OK

General Provider Information

NPI Number : 1790502342
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA WALLAIN LPC
Provider Business Mailing Address
First Line : 9228 S MINGO RD STE 101
Second Line :
City : TULSA
State : OK
Zip : 74133-5721
Country : US
Telephone Number : 405-378-2727
Fax Number :
Provider Business Practice Location Address
First Line : 9228 S MINGO RD STE 101
Second Line :
City : TULSA
State : OK
Zip : 74133-5721
Country : US
Telephone Number : 405-378-2727
Fax Number : 405-378-2776
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2024
Last Update Date : 06/29/2026

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Directions to “ MELISSA WALLAIN LPC” Practice Location

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