Provider Information for 1467778043
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Mrs. MELISSA JORDAN GUARNACCIA MSW, LCSW
Sex: Female
NPI: 1467778043
Last Updated: 2010-04-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1467778043 | ||||||||
| Enumeration Date | 2010-04-08 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3541 RANDOLPH ROAD SUITE 206 CHARLOTTE, NC 28211-1009 United States Phone: 704-381-8360 | Fax:704-381-8832 | ||||||||
| Primary Practice Address | 3541 RANDOLPH ROAD SUITE 206 CHARLOTTE, NC 28211-1009 United States Phone: 704-381-8360 | Fax:704-381-8832 | ||||||||
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