Provider Demographics
NPI:1184089302
Name:MELOY, ANNA (LISW-S)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:MELOY
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1763 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:N COLLEGE HL
Mailing Address - State:OH
Mailing Address - Zip Code:45224-2801
Mailing Address - Country:US
Mailing Address - Phone:513-503-0545
Mailing Address - Fax:
Practice Address - Street 1:1763 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:N COLLEGE HL
Practice Address - State:OH
Practice Address - Zip Code:45224-2801
Practice Address - Country:US
Practice Address - Phone:513-503-0545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
I.1450967-SUPV104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker