Provider Demographics
NPI:1639862519
Name:ROSETTA, MELISSA RUTH (LPA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:RUTH
Last Name:ROSETTA
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 BROOKCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-1841
Mailing Address - Country:US
Mailing Address - Phone:828-399-1012
Mailing Address - Fax:
Practice Address - Street 1:24 BROOKCLIFF DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-1841
Practice Address - Country:US
Practice Address - Phone:828-399-1012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5728103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist