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NPI Code Detail

MEDICARE: RONDA MELCHIORRE LPC CANDIDATE

MEDICARE: RONDA MELCHIORRE LPC CANDIDATE
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1396511069
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONDA MELCHIORRE LPC CANDIDATE
Provider Business Mailing Address
First Line : 11002 S MADISON ST
Second Line :
City : JENKS
State : OK
Zip : 74037-1803
Country : US
Telephone Number : 918-798-4301
Fax Number :
Provider Business Practice Location Address
First Line : 2448 E 81ST ST STE 4460
Second Line :
City : TULSA
State : OK
Zip : 74137-4251
Country : US
Telephone Number : 918-798-4301
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2023
Last Update Date : 12/04/2023

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Directions to “ RONDA MELCHIORRE LPC CANDIDATE” Practice Location

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