Provider Demographics
NPI:1558024745
Name:MELHORN, REBECCA ROSE
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ROSE
Last Name:MELHORN
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 1:1246 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-3664
Mailing Address - Country:US
Mailing Address - Phone:914-826-5081
Mailing Address - Fax:
Practice Address - Street 1:1246 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-3664
Practice Address - Country:US
Practice Address - Phone:914-826-5081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health