Provider Demographics
NPI:1821709783
Name:FIGUEROA, MELISSA ANN (WVCPRSS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:WVCPRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 STUART ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-1325
Mailing Address - Country:US
Mailing Address - Phone:304-531-8056
Mailing Address - Fax:
Practice Address - Street 1:1206 QUARRIER ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1843
Practice Address - Country:US
Practice Address - Phone:304-444-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22-9115175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist