Provider Demographics
NPI:1942487152
Name:WALBORN, MELANIE A (MTBC)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:A
Last Name:WALBORN
Suffix:
Gender:F
Credentials:MTBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7728 GREEN HILL RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-9746
Mailing Address - Country:US
Mailing Address - Phone:717-468-1684
Mailing Address - Fax:717-566-6556
Practice Address - Street 1:119 N 8TH ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17046-5011
Practice Address - Country:US
Practice Address - Phone:717-468-1684
Practice Address - Fax:717-566-6556
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA225A00000XMedicaid