Provider Demographics
NPI:1942709100
Name:GILLETT, MELISSA (QMHS)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:GILLETT
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:GILLET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:QMHS
Mailing Address - Street 1:PO BOX 328857
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-8857
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5665 HOOVER RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-9122
Practice Address - Country:US
Practice Address - Phone:614-875-2371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor