Provider Demographics
NPI:1538495007
Name:OHDEN, MELISSA A (LISW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:OHDEN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 1ST ST NE STE 103
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51041-1456
Mailing Address - Country:US
Mailing Address - Phone:712-737-2635
Mailing Address - Fax:712-737-2344
Practice Address - Street 1:209 1ST ST NE STE 103
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:IA
Practice Address - Zip Code:51041-1456
Practice Address - Country:US
Practice Address - Phone:712-737-2635
Practice Address - Fax:712-737-2344
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA065821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical