Provider Demographics
NPI:1073831095
Name:BACULIMA, MELANIE HOPE (MSW)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:HOPE
Last Name:BACULIMA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1973 SW SWIFT AVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-8004
Mailing Address - Country:US
Mailing Address - Phone:954-336-8743
Mailing Address - Fax:
Practice Address - Street 1:1973 SW SWIFT AVE
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-8004
Practice Address - Country:US
Practice Address - Phone:954-336-8743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical