Provider Demographics
NPI:1336659580
Name:SPIKE, MELINDA ERIN (LAC, COMT, CHC)
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:ERIN
Last Name:SPIKE
Suffix:
Gender:F
Credentials:LAC, COMT, CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7275 147TH ST W STE 103B
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7809
Mailing Address - Country:US
Mailing Address - Phone:952-378-7894
Mailing Address - Fax:
Practice Address - Street 1:7275 147TH ST W STE 103B
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7809
Practice Address - Country:US
Practice Address - Phone:952-378-7894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1812171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist