Provider Demographics
NPI:1407226442
Name:MARINELLO, MELISSA
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MARINELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 JULIE RD
Mailing Address - Street 2:
Mailing Address - City:SANATOGA
Mailing Address - State:PA
Mailing Address - Zip Code:19464-7212
Mailing Address - Country:US
Mailing Address - Phone:610-772-1216
Mailing Address - Fax:
Practice Address - Street 1:301 CIRCLE OF PROGRESS DR
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3811
Practice Address - Country:US
Practice Address - Phone:610-970-5410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)