Provider Demographics
NPI:1225449523
Name:ENGEL, MELODY
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:
Last Name:ENGEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELODY
Other - Middle Name:CAROL
Other - Last Name:ENGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA LBS
Mailing Address - Street 1:1720 PINEWIND DR
Mailing Address - Street 2:
Mailing Address - City:ALBURTIS
Mailing Address - State:PA
Mailing Address - Zip Code:18011-2708
Mailing Address - Country:US
Mailing Address - Phone:484-695-4905
Mailing Address - Fax:
Practice Address - Street 1:1720 PINEWIND DR
Practice Address - Street 2:
Practice Address - City:ALBURTIS
Practice Address - State:PA
Practice Address - Zip Code:18011-2708
Practice Address - Country:US
Practice Address - Phone:484-695-4905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000375101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health