Provider Demographics
NPI:1851499073
Name:SHMOIS, MELANIE J (MSSA)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:J
Last Name:SHMOIS
Suffix:
Gender:F
Credentials:MSSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-1004
Mailing Address - Country:US
Mailing Address - Phone:216-225-8602
Mailing Address - Fax:
Practice Address - Street 1:223 MILLER RD
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-1004
Practice Address - Country:US
Practice Address - Phone:440-930-2002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI96651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical