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General NPI Number Information
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NPI Number | 1447398417
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Entity Type | Individual
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Provider Name | MS. PATRICIA ANNE MELCO
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Gender | Female
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2200 UNIVERSITY AVE INTERIM HEALTH CARE SUITE #160
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City | ST PAUL
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State | MN
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Zip | 55114
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Country | US
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Telephone | 651-917-3634
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Fax | 651-917-3620
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Provider Business Mailing Address
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Address Line | 1366 WESTMINISTER STREET APT #105B
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City | ST PAUL
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State | MN
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Zip | 55130-3344
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Country | US
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Telephone | 651-771-1891
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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