Provider Demographics
NPI:1073973517
Name:WEINRICH, MELISSA QUIMBY
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:QUIMBY
Last Name:WEINRICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:QUIMBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:2324 THAYER AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5364
Mailing Address - Country:US
Mailing Address - Phone:949-525-1286
Mailing Address - Fax:
Practice Address - Street 1:2324 THAYER AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-5364
Practice Address - Country:US
Practice Address - Phone:949-525-1286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator