Provider Demographics
NPI:1922332386
Name:BARTNICK, MELISSA MARY (BA)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:MARY
Last Name:BARTNICK
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:13144 MACNEIL CT
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48380-3082
Mailing Address - Country:US
Mailing Address - Phone:248-684-8747
Mailing Address - Fax:
Practice Address - Street 1:6918 WINDSOR AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3334
Practice Address - Country:US
Practice Address - Phone:708-745-5277
Practice Address - Fax:708-795-4834
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health