Provider Information for 1235906116
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MELISSA HANDT MSW, LICSW
Other Names:Former Name:MELISSA OTTEN MSW, LICSWSex: Female
NPI: 1235906116
Last Updated: 2024-06-03
Certification Date: 2024-06-03
Certification Date: 2024-06-03
Details
| Name | Value | ||||||||||||
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| NPI | 1235906116 | ||||||||||||
| Enumeration Date | 2023-12-11 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 2031 ROWLAND RD MORA, MN 55051-7119 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 2031 ROWLAND RD MORA, MN 55051-7119 United States Phone: 320-364-1300 | Fax: | ||||||||||||
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