Provider Demographics
NPI:1114072212
Name:GUILBEAULT, MELISSA LEIGH (MED)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:LEIGH
Last Name:GUILBEAULT
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LEIGH
Other - Last Name:CUSSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:270 BENTON DR
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-3233
Mailing Address - Country:US
Mailing Address - Phone:413-567-9993
Mailing Address - Fax:
Practice Address - Street 1:270 BENTON DR
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-3233
Practice Address - Country:US
Practice Address - Phone:413-567-9993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health