MEDICARE: MELISSA MANDELL

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	104100000X	Social Worker	23935	MD

General Provider Information

NPI Number	:	1619790763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA MANDELL

Provider Business Mailing Address
First Line	:	2717 SNOWBIRD TER APT 9
Second Line	:
City	:	ASPEN HILL
State	:	MD
Zip	:	20906-6176
Country	:	US
Telephone Number	:	240-888-1593
Fax Number	:

Provider Business Practice Location Address
First Line	:	2717 SNOWBIRD TER APT 9
Second Line	:
City	:	ASPEN HILL
State	:	MD
Zip	:	20906-6176
Country	:	US
Telephone Number	:	240-888-1593
Fax Number	:

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

Provider Enumeration Date	:	11/06/2024
Last Update Date	:	11/06/2024

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Directions to “ MELISSA MANDELL ” Practice Location

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