Provider Demographics
NPI:1669178323
Name:SCHMIDT, MELISSA LEIGH (CHES)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LEIGH
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:CHES
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LEIGH
Other - Last Name:HADDLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:129 W LONG CREEK CT
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-6222
Mailing Address - Country:US
Mailing Address - Phone:330-774-5098
Mailing Address - Fax:
Practice Address - Street 1:129 W LONG CREEK CT
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29680-6222
Practice Address - Country:US
Practice Address - Phone:330-774-5098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH25011174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator