Provider Demographics
NPI:1659137743
Name:MANSIKA, MELISSA ANNE HOLLAND (MS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANNE HOLLAND
Last Name:MANSIKA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANNE
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:2525 ARAPAHOE AVE STE E4-413
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-6720
Mailing Address - Country:US
Mailing Address - Phone:720-310-0441
Mailing Address - Fax:
Practice Address - Street 1:4453 RUSTIC TRL
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3920
Practice Address - Country:US
Practice Address - Phone:720-295-8440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach