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General NPI Number Information
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NPI Number | 1801587605
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Entity Type | Individual
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Provider Name | NATHAN RICHARD MELOTTI
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Gender | Male
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Dates
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Enumeration Date | 05/15/2023
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 913 W HOLMES RD STE 200
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City | LANSING
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State | MI
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Zip | 48910-0411
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Country | US
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Telephone | 517-887-0226
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Fax |
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Provider Business Mailing Address
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Address Line | 312 N CLINTON AVE APT 3
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City | SAINT JOHNS
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State | MI
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Zip | 48879-2502
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Country | US
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Telephone | 616-617-0493
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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