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General NPI Number Information
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NPI Number | 1467590745
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Entity Type | Individual
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Provider Name | MELISSA MARIE LEFEVERS BS
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Gender | Female
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 109 W WATAUGA AVENUE
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City | JOHNSON CITY
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State | TN
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Zip | 37604
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Country | US
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Telephone | 423-232-2700
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Fax | 423-232-2714
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Provider Business Mailing Address
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Address Line | 3 MOUNTAIN RIDGES CT
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City | JONESBOROUGH
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State | TN
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Zip | 37659-6482
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Country | US
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Telephone | 423-753-4980
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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 |
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License Number State |
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