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General NPI Number Information
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NPI Number | 1346356508
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Entity Type | Individual
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Provider Name | MS. MELODIE LOUISE COOEY
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Gender | Female
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3550 WATT AVE STE 180
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City | SACRAMENTO
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State | CA
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Zip | 95821-2698
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Country | US
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Telephone | 916-832-6943
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Fax | 916-484-6917
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Provider Business Mailing Address
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Address Line | 921 CASTEC DR
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City | SACRAMENTO
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State | CA
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Zip | 95864-2845
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Country | US
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Telephone | 916-484-6917
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC41799
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License Number State | CA
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