Provider Demographics
NPI:1346095320
Name:DOUKAS, MELISSA MARIA (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIA
Last Name:DOUKAS
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 PHEASANT RUN DR
Mailing Address - Street 2:
Mailing Address - City:GALES FERRY
Mailing Address - State:CT
Mailing Address - Zip Code:06335-2018
Mailing Address - Country:US
Mailing Address - Phone:860-373-3096
Mailing Address - Fax:
Practice Address - Street 1:24 PHEASANT RUN DR
Practice Address - Street 2:
Practice Address - City:GALES FERRY
Practice Address - State:CT
Practice Address - Zip Code:06335-2018
Practice Address - Country:US
Practice Address - Phone:860-373-3096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach