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General NPI Number Information
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NPI Number | 1427458462
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Entity Type | Individual
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Provider Name | AMY MELLO LICSW
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Gender | Female
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Dates
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Enumeration Date | 08/27/2014
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Last Update Date | 08/27/2014
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Provider Practice Location Address
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Address Line | 25 HARRIS DRIVE
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City | TIVERTON
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State | RI
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Zip | 02878
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Country | US
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Telephone | 401-935-1094
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 864
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City | TIVERTON
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State | RI
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Zip | 02878
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Country | US
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Telephone | 401-935-1094
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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 | ISW02462
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License Number State | RI
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