Provider Demographics
NPI:1598099152
Name:GRATTAN, MELISSA JOY (MS ED)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:JOY
Last Name:GRATTAN
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 JUNIPER DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-4721
Mailing Address - Country:US
Mailing Address - Phone:518-366-1901
Mailing Address - Fax:
Practice Address - Street 1:2 JUNIPER DR
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-4721
Practice Address - Country:US
Practice Address - Phone:518-366-1901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator