Provider Demographics
NPI:1710205307
Name:HERRMANN, MELANIE G (MS)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:G
Last Name:HERRMANN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2072 N MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:NORTH LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-1778
Mailing Address - Country:US
Mailing Address - Phone:435-754-4959
Mailing Address - Fax:
Practice Address - Street 1:2072 N MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:NORTH LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-1778
Practice Address - Country:US
Practice Address - Phone:435-754-4959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath