Provider Demographics
NPI:1205383411
Name:ARDOIN, MELISSA LEE (JD, MS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LEE
Last Name:ARDOIN
Suffix:
Gender:F
Credentials:JD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 HEYMANN BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2322
Mailing Address - Country:US
Mailing Address - Phone:337-504-4279
Mailing Address - Fax:337-504-4692
Practice Address - Street 1:106 HEYMANN BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2322
Practice Address - Country:US
Practice Address - Phone:337-504-4279
Practice Address - Fax:337-504-4692
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health