Provider Demographics
NPI:1700034576
Name:SECOLA NIEFT, MELISA MARIE (PHD)
Entity Type:Individual
Prefix:PROF
First Name:MELISA
Middle Name:MARIE
Last Name:SECOLA NIEFT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 WAIANUENUE AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2489
Mailing Address - Country:US
Mailing Address - Phone:808-961-7018
Mailing Address - Fax:808-961-7099
Practice Address - Street 1:214 WAIANUENUE AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2489
Practice Address - Country:US
Practice Address - Phone:808-961-7018
Practice Address - Fax:808-961-7099
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC -152101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health