Provider Demographics
NPI:1952655284
Name:MELTZ, BARBARA JEAN
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEAN
Last Name:MELTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1683 ROCKVIEW RD APT 2
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:IL
Mailing Address - Zip Code:61021-8779
Mailing Address - Country:US
Mailing Address - Phone:630-886-3163
Mailing Address - Fax:
Practice Address - Street 1:322 DEPOT AVE
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:IL
Practice Address - Zip Code:61021-2850
Practice Address - Country:US
Practice Address - Phone:815-288-6057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health