Provider Demographics
NPI:1265725279
Name:SALEH, MELONIE LILA (LMFT)
Entity type:Individual
Prefix:
First Name:MELONIE
Middle Name:LILA
Last Name:SALEH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 10TH ST # 497
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95354-2305
Mailing Address - Country:US
Mailing Address - Phone:209-735-8367
Mailing Address - Fax:209-497-4864
Practice Address - Street 1:800 SCENIC DR BLDG 4
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-6131
Practice Address - Country:US
Practice Address - Phone:888-376-6246
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-24
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT98835106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist