MEDICARE: MELODY DAY

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	101YM0800X	Mental Health Counselor	LAC-5972T	AZ

General Provider Information

NPI Number	:	1952821100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELODY DAY

Provider Business Mailing Address
First Line	:	152 N POWER RD STE 2
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85205-8436
Country	:	US
Telephone Number	:	253-380-3293
Fax Number	:

Provider Business Practice Location Address
First Line	:	152 N POWER RD
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85205-8436
Country	:	US
Telephone Number	:	253-380-3293
Fax Number	:

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

Provider Enumeration Date	:	06/20/2017
Last Update Date	:	11/27/2018

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Directions to “ MELODY DAY ” Practice Location

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