Provider Demographics
NPI:1760102412
Name:CANET, MELISSA ANN (LPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:CANET
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 JUDY DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76705-5242
Mailing Address - Country:US
Mailing Address - Phone:254-366-0734
Mailing Address - Fax:
Practice Address - Street 1:140 JUDY DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76705-5242
Practice Address - Country:US
Practice Address - Phone:254-366-0734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73686101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty