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NPI 1467652487

NPI 1467652487 : MELANIE CARLA PISTILLI MED./CADC : WILMINGTON, DE

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General NPI Number Information
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    NPI Number           |    1467652487
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    Entity Type          |    Individual 
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    Provider Name        |    MELANIE CARLA PISTILLI MED./CADC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/18/2007
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    Last Update Date     |    02/02/2011
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Provider Practice Location Address
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    Address Line         |    2501 EBRIGHT ROAD 
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    City                 |    WILMINGTON
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    State                |    DE
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    Zip                  |    19810-1198
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    Country              |    US
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    Telephone            |    302-477-3960
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    Fax                  |    302-477-3963
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Provider Business Mailing Address
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    Address Line         |    2501 EBRIGHT RD 
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    City                 |    WILMINGTON
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    State                |    DE
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    Zip                  |    19810-1125
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    Country              |    US
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    Telephone            |    302-477-3960
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    Fax                  |    302-477-3963
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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        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    635
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    License Number State |    DE
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