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NPI Code Detail

MEDICARE: MELANIE ANN ANNEAR

MEDICARE:   MELANIE ANN ANNEAR
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
1322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1902299647
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELANIE ANN ANNEAR
Provider Business Mailing Address
First Line : 198 NW REED LANE
Second Line :
City : DALLAS
State : OR
Zip : 97338
Country : US
Telephone Number : 503-798-1878
Fax Number :
Provider Business Practice Location Address
First Line : 435 NE EVANS ST STE A
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-4628
Country : US
Telephone Number : 503-472-4020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2015
Last Update Date : 05/22/2020

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Directions to “ MELANIE ANN ANNEAR ” Practice Location

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