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General NPI Number Information
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NPI Number | 1619220100
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Entity Type | Individual
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Provider Name | MELISSA LEIGH RABY MA, MSW, LCSW, CSOTP
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Gender | Female
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Dates
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Enumeration Date | 10/21/2012
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Last Update Date | 01/18/2013
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Provider Practice Location Address
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Address Line | 9736 LEW JONES RD
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City | MC KENNEY
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State | VA
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Zip | 23872-2936
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Country | US
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Telephone | 804-478-5006
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 27
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City | MC KENNEY
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State | VA
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Zip | 23872
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Country | US
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Telephone | 804-478-5006
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904007084
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License Number State | VA
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