Provider Demographics
NPI:1396839064
Name:MELO, XIOMARA ELIZABETH (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:XIOMARA
Middle Name:ELIZABETH
Last Name:MELO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 TENNESSEE ST
Mailing Address - Street 2:APT 321
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-4469
Mailing Address - Country:US
Mailing Address - Phone:901-833-3830
Mailing Address - Fax:
Practice Address - Street 1:505 TENNESSEE ST
Practice Address - Street 2:APT 321
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-4469
Practice Address - Country:US
Practice Address - Phone:901-833-3830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000051961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical