Provider Demographics
NPI:1346306727
Name:WEST, MELISSA L (MS, CGC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:L
Last Name:WEST
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:L
Other - Last Name:SOPKO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:8901 W LINCOLN AVE
Mailing Address - Street 2:SUITE 505
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2409
Mailing Address - Country:US
Mailing Address - Phone:414-329-5685
Mailing Address - Fax:414-329-5601
Practice Address - Street 1:8901 W LINCOLN AVE
Practice Address - Street 2:SUITE 505
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-2409
Practice Address - Country:US
Practice Address - Phone:414-329-5685
Practice Address - Fax:414-329-5601
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS