Provider Demographics
NPI:1801134333
Name:MILLS-JUHASZ, MELANIE LYNN
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:LYNN
Last Name:MILLS-JUHASZ
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:PO BOX 444
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:OH
Mailing Address - Zip Code:44265-0444
Mailing Address - Country:US
Mailing Address - Phone:330-603-0959
Mailing Address - Fax:330-325-7063
Practice Address - Street 1:1485 STATE ROUTE 44
Practice Address - Street 2:UNIT D
Practice Address - City:ATWATER
Practice Address - State:OH
Practice Address - Zip Code:44201-9267
Practice Address - Country:US
Practice Address - Phone:330-325-7390
Practice Address - Fax:330-325-7390
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.020660-L225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist