Provider Demographics
NPI:1992187363
Name:VALENTINE, MELISSA
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:VALENTINE
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 1:111 S MULBERRY ST
Mailing Address - Street 2:A
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-3307
Mailing Address - Country:US
Mailing Address - Phone:740-393-6001
Mailing Address - Fax:740-393-6040
Practice Address - Street 1:111 S MULBERRY ST
Practice Address - Street 2:A
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-3307
Practice Address - Country:US
Practice Address - Phone:740-393-6001
Practice Address - Fax:740-393-6040
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional