Provider Demographics
NPI:1497045140
Name:WOJTKOWSKI, MELISSA L (MS)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:L
Last Name:WOJTKOWSKI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:L
Other - Last Name:SCHERER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:92 SUMMER ST.
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:MA
Mailing Address - Zip Code:01005
Mailing Address - Country:US
Mailing Address - Phone:774-239-4002
Mailing Address - Fax:978-355-3501
Practice Address - Street 1:35 SOUTH ST
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:MA
Practice Address - Zip Code:01005
Practice Address - Country:US
Practice Address - Phone:774-239-4002
Practice Address - Fax:978-355-3501
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-14
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5431101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health