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General NPI Number Information
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NPI Number | 1447011192
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Entity Type | Organization
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Legal Business Name | MELISSA BOLTON COUNSELING, PLLC
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Dates
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Enumeration Date | 01/19/2024
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 3150 LIVERNOIS RD STE 275
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City | TROY
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State | MI
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Zip | 48083-5034
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Country | US
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Telephone | 248-457-5401
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Fax |
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Provider Business Mailing Address
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Address Line | 304 N GAINSBOROUGH AVE
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City | ROYAL OAK
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State | MI
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Zip | 48067-1937
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Country | US
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Telephone | 904-599-6281
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MELISSA BOLTON
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Credential | LPC
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Telephone | 904-599-6281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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