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NPI Code Detail

MEDICARE: MELISSA TRISTINE LETT

MEDICARE: MELISSA TRISTINE LETT
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
1104100000XSocial Worker97221CA
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1871844126
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA TRISTINE LETT
Provider Business Mailing Address
First Line : 177 W HENDERSON AVE STE 1
Second Line :
City : PORTERVILLE
State : CA
Zip : 93257-1777
Country : US
Telephone Number : 559-784-0312
Fax Number :
Provider Business Practice Location Address
First Line : 177 W HENDERSON AVE STE 1
Second Line :
City : PORTERVILLE
State : CA
Zip : 93257-1777
Country : US
Telephone Number : 559-784-0312
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2012
Last Update Date : 12/27/2022

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Directions to “ MELISSA TRISTINE LETT ” Practice Location

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