Healthcare Provider Details

I. General information

NPI: 1861665853
Provider Name (Legal Business Name): MELISSA NICHOLE ROUGIER MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 JOHN ST 1ST FLOOR
LOWELL MA
01852-1101
US

IV. Provider business mailing address

35 JOHN ST 1ST FLOOR
LOWELL MA
01852-1101
US

V. Phone/Fax

Practice location:
  • Phone: 978-275-3879
  • Fax: 978-275-6480
Mailing address:
  • Phone: 978-275-3879
  • Fax: 978-275-6480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: