Provider Demographics
NPI:1538465455
Name:DRAKE, MELODI (MSW)
Entity Type:Individual
Prefix:
First Name:MELODI
Middle Name:
Last Name:DRAKE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31808
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59107-1808
Mailing Address - Country:US
Mailing Address - Phone:406-861-4701
Mailing Address - Fax:
Practice Address - Street 1:208 N 29TH ST STE 232
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1926
Practice Address - Country:US
Practice Address - Phone:406-861-4701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-10
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical