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General NPI Number Information
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NPI Number | 1508242181
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Entity Type | Individual
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Provider Name | MARY PAT MELVIN LSW
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Gender | Female
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Dates
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Enumeration Date | 08/05/2015
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Last Update Date | 08/05/2015
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Provider Practice Location Address
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Address Line | 9 N MAIN ST
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City | PITTSTON
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State | PA
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Zip | 18640-1836
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Country | US
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Telephone | 570-654-0788
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Fax |
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Provider Business Mailing Address
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Address Line | 9 N MAIN ST PO BOX 315
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City | PITTSTON
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State | PA
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Zip | 18640-1836
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Country | US
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Telephone | 570-654-0788
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW009917L
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License Number State | PA
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