Provider Demographics
NPI:1033723713
Name:ROJAS-TOTO, MELINDA MICHELLE
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:MICHELLE
Last Name:ROJAS-TOTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10420 N EMIG AVE
Mailing Address - Street 2:
Mailing Address - City:HAYDEN
Mailing Address - State:ID
Mailing Address - Zip Code:83835-7204
Mailing Address - Country:US
Mailing Address - Phone:208-916-6560
Mailing Address - Fax:
Practice Address - Street 1:10420 N EMIG AVE
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-7204
Practice Address - Country:US
Practice Address - Phone:208-916-6560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist