Provider Demographics
NPI:1760785166
Name:FIJOL, MELISSA LEIGH
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LEIGH
Last Name:FIJOL
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 1:160 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITINSVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01588-1835
Mailing Address - Country:US
Mailing Address - Phone:617-755-1379
Mailing Address - Fax:
Practice Address - Street 1:160 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITINSVILLE
Practice Address - State:MA
Practice Address - Zip Code:01588-1835
Practice Address - Country:US
Practice Address - Phone:617-755-1379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor