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General NPI Number Information
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NPI Number | 1093331878
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Entity Type | Individual
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Provider Name | MELISSA STARR
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Gender | Female
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Dates
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Enumeration Date | 06/17/2020
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Last Update Date | 06/17/2020
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Provider Practice Location Address
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Address Line | 502 E 2ND ST
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City | DULUTH
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State | MN
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Zip | 55805-1913
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Country | US
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Telephone | 218-786-5869
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Fax |
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Provider Business Mailing Address
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Address Line | 2605 W 2ND ST
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City | DULUTH
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State | MN
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Zip | 55806-1852
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Country | US
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Telephone | 218-461-5481
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 25691
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License Number State | MN
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