MEDICARE: MELISSA TATUM MONROE

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	101YP2500X	Professional Counselor	7980	LA

General Provider Information

NPI Number	:	1518289149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA TATUM MONROE

Provider Business Mailing Address
First Line	:	109 ARBOR COVE CIR
Second Line	:
City	:	WEST MONROE
State	:	LA
Zip	:	71291-1779
Country	:	US
Telephone Number	:	318-348-5431
Fax Number	:

Provider Business Practice Location Address
First Line	:	4306 S GRAND ST
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71202-6322
Country	:	US
Telephone Number	:	318-324-5441
Fax Number	:

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

Provider Enumeration Date	:	02/23/2010
Last Update Date	:	03/12/2020

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Directions to “ MELISSA TATUM MONROE ” Practice Location

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