Provider Demographics
NPI:1760009435
Name:POSTOLOWSKI, MELENA NICOLE
Entity Type:Individual
Prefix:
First Name:MELENA
Middle Name:NICOLE
Last Name:POSTOLOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 COUNTRY TRAILS DR
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-2015
Mailing Address - Country:US
Mailing Address - Phone:386-262-5676
Mailing Address - Fax:
Practice Address - Street 1:2750 N MCMULLEN BOOTH RD STE 102E
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-3362
Practice Address - Country:US
Practice Address - Phone:727-513-6750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist