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NPI Code Detail

MEDICARE: MS. KRISTEN MICHELLE MELTON

MEDICARE: MS. KRISTEN MICHELLE MELTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMI0219NV

General Provider Information

NPI Number : 1073810305
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISTEN MICHELLE MELTON
Provider Business Mailing Address
First Line : 2920 S JONES BLVD
Second Line : SUITE 230
City : LAS VEGAS
State : NV
Zip : 89146-5395
Country : US
Telephone Number : 702-806-5268
Fax Number : 702-485-1107
Provider Business Practice Location Address
First Line : 2920 S JONES BLVD
Second Line : SUITE 230
City : LAS VEGAS
State : NV
Zip : 89146-5395
Country : US
Telephone Number : 702-806-5268
Fax Number : 702-485-1107
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2011
Last Update Date : 02/23/2011

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