Provider Demographics
NPI:1992006290
Name:NOLAN, MELISSA A
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:A
Last Name:NOLAN
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 1:7858 RUSSLING LEAF DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-8292
Mailing Address - Country:US
Mailing Address - Phone:702-647-4459
Mailing Address - Fax:
Practice Address - Street 1:7858 RUSSLING LEAF DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-8292
Practice Address - Country:US
Practice Address - Phone:702-647-4459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health