MEDICARE: MELINDA COFFEY

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
1	103TS0200X	School Psychologist

General Provider Information

NPI Number	:	1285054973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINDA COFFEY

Provider Business Mailing Address
First Line	:	2121 W 67TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-4316
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 W 67TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-4316
Country	:	US
Telephone Number	:	216-961-1753
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2014
Last Update Date	:	04/21/2014

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Directions to “ MELINDA COFFEY ” Practice Location

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