Provider Demographics
NPI:1639470818
Name:MANSEAU, MELANIE
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:MANSEAU
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 1:320 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST NEWBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01985-1420
Mailing Address - Country:US
Mailing Address - Phone:978-363-5553
Mailing Address - Fax:978-363-2435
Practice Address - Street 1:320 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST NEWBURY
Practice Address - State:MA
Practice Address - Zip Code:01985
Practice Address - Country:US
Practice Address - Phone:978-363-5553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor