Provider Demographics
NPI:1689734469
Name:ISBELL, MELISSA (BS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ISBELL
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DECATURVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38329-8033
Mailing Address - Country:US
Mailing Address - Phone:731-852-3112
Mailing Address - Fax:731-852-3222
Practice Address - Street 1:259 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DECATURVILLE
Practice Address - State:TN
Practice Address - Zip Code:38329-8033
Practice Address - Country:US
Practice Address - Phone:731-852-3112
Practice Address - Fax:731-852-3222
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor