Provider Demographics
NPI:1629345186
Name:CURTIS, MELANIE
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:CURTIS
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 1:3048 BEAUFORD ST
Mailing Address - Street 2:
Mailing Address - City:ROBINSON
Mailing Address - State:TX
Mailing Address - Zip Code:76706-7447
Mailing Address - Country:US
Mailing Address - Phone:254-855-0509
Mailing Address - Fax:
Practice Address - Street 1:900 AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76701-1902
Practice Address - Country:US
Practice Address - Phone:254-307-0178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX502921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical