Provider Demographics
NPI:1376620880
Name:RAWLINS, MELANIE E (PHD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:E
Last Name:RAWLINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 SHOREWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:IL
Mailing Address - Zip Code:61455-9746
Mailing Address - Country:US
Mailing Address - Phone:309-837-4139
Mailing Address - Fax:309-837-4139
Practice Address - Street 1:28 SHOREWOOD DR
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:IL
Practice Address - Zip Code:61455-9746
Practice Address - Country:US
Practice Address - Phone:309-837-4139
Practice Address - Fax:309-837-4139
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical