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NPI Code Detail

MEDICARE: MS. MELISSA LEE SPEELMAN MSW LISW

MEDICARE: MS. MELISSA LEE SPEELMAN MSW LISW
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
11041C0700XClinical Social WorkerI0009287OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578541744
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MELISSA LEE SPEELMAN MSW LISW
Provider Business Mailing Address
First Line : 151 MARION AVE
Second Line :
City : MANSFIELD
State : OH
Zip : 44903-2223
Country : US
Telephone Number : 419-774-9969
Fax Number :
Provider Business Practice Location Address
First Line : 151 MARION AVE
Second Line :
City : MANSFIELD
State : OH
Zip : 44903-2223
Country : US
Telephone Number : 419-774-9969
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 03/17/2018

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