Provider Demographics
NPI:1700553369
Name:PAZDON, MELISSA (MED)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:PAZDON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 N SPRING ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3918
Mailing Address - Country:US
Mailing Address - Phone:603-225-0840
Mailing Address - Fax:
Practice Address - Street 1:17 N SPRING ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3918
Practice Address - Country:US
Practice Address - Phone:603-225-0840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH91103103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool