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General NPI Number Information
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NPI Number | 1457738940
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Entity Type | Individual
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Provider Name | MELANIE LETT
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Gender | Female
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Dates
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Enumeration Date | 05/04/2015
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Last Update Date | 06/02/2017
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Provider Practice Location Address
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Address Line | 2265 LIVERNOIS RD SUITE 701
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City | TROY
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State | MI
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Zip | 48083-1633
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Country | US
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Telephone | 248-770-3576
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Fax |
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Provider Business Mailing Address
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Address Line | 2265 LIVERNOIS #701
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City | TROY
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State | MI
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Zip | 48083
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Country | US
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Telephone | 248-649-8050
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401011677
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License Number State | MI
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