Provider Demographics
NPI:1437790987
Name:STRATTON, MELISSA ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ELIZABETH
Last Name:STRATTON
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 1:310 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14904-1458
Mailing Address - Country:US
Mailing Address - Phone:607-737-2490
Mailing Address - Fax:
Practice Address - Street 1:310 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14904-1458
Practice Address - Country:US
Practice Address - Phone:607-737-2490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2019-10-23
Deactivation Date:2019-10-07
Deactivation Code:
Reactivation Date:2019-10-23
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker