MEDICARE: MELANIE DIANE BARRAZA LCSW

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	2084P0800X	Psychiatry Physician	1873C	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51531261	OTHER	AL	BCBS

General Provider Information

NPI Number	:	1922053925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE DIANE BARRAZA LCSW

Provider Business Mailing Address
First Line	:	3322 MEMORIAL PKWY SW
Second Line	:	SUITE 423
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-5366
Country	:	US
Telephone Number	:	256-880-0556
Fax Number	:	256-705-4419

Provider Business Practice Location Address
First Line	:	3322 MEMORIAL PKWY SW
Second Line	:	SUITE 423
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-5366
Country	:	US
Telephone Number	:	256-880-0556
Fax Number	:	256-705-4419

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	07/08/2007

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Directions to “ MELANIE DIANE BARRAZA LCSW” Practice Location

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