Provider Demographics
NPI:1013283027
Name:CAPPELLO, MELINIE LYNN (DD)
Entity type:Individual
Prefix:DR
First Name:MELINIE
Middle Name:LYNN
Last Name:CAPPELLO
Suffix:
Gender:F
Credentials:DD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 S MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-1914
Mailing Address - Country:US
Mailing Address - Phone:616-402-0321
Mailing Address - Fax:
Practice Address - Street 1:276 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-1914
Practice Address - Country:US
Practice Address - Phone:616-402-0321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-24
Last Update Date:2012-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA144244OtherULM