Healthcare Provider Details

I. General information

NPI: 1902229685
Provider Name (Legal Business Name): MELISSA TIHIN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2014
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 E SHAW AVE #103
FRESNO CA
93710-7717
US

IV. Provider business mailing address

770 E SHAW AVE #103
FRESNO CA
93710-7717
US

V. Phone/Fax

Practice location:
  • Phone: 559-500-9355
  • Fax: 559-532-0202
Mailing address:
  • Phone: 559-500-9355
  • Fax: 559-253-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number86602
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: