Provider Demographics
NPI:1831610591
Name:MELIGY, AIMEE MONA
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:MONA
Last Name:MELIGY
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 1:2124 DUPONT AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-2700
Mailing Address - Country:US
Mailing Address - Phone:800-336-5953
Mailing Address - Fax:
Practice Address - Street 1:8120 PENN AVE S STE 400
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-1311
Practice Address - Country:US
Practice Address - Phone:800-336-5973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1489101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional