Provider Demographics
NPI:1942511092
Name:DIGMANN, MELISSA BENEDETTO (LISW)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:BENEDETTO
Last Name:DIGMANN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:RAE
Other - Last Name:BENEDETTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:3370 HIBISCUS LN
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-1716
Mailing Address - Country:US
Mailing Address - Phone:319-651-6710
Mailing Address - Fax:
Practice Address - Street 1:3343 CENTER GROVE DR
Practice Address - Street 2:SUITE A
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52003-5264
Practice Address - Country:US
Practice Address - Phone:319-651-6710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0068991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical