Provider Demographics
NPI:1639259575
Name:COX-PASQUA, MELISSA ANN (BSN, RN, MAPC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANN
Last Name:COX-PASQUA
Suffix:
Gender:F
Credentials:BSN, RN, MAPC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7776 S POINTE PKWY W
Mailing Address - Street 2:SUITE 160
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-5423
Mailing Address - Country:US
Mailing Address - Phone:602-821-3836
Mailing Address - Fax:
Practice Address - Street 1:7776 S POINTE PKWY W
Practice Address - Street 2:SUITE 160
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-5423
Practice Address - Country:US
Practice Address - Phone:602-821-3836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-13764101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ37-1653845OtherEIN - BUSINESS TAX ID