Provider Information for 1659017697
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MELISSA MCMAHON LPC
Sex: Female
NPI: 1659017697
Last Updated: 2022-05-11
Certification Date: 2022-04-28
Certification Date: 2022-04-28
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1659017697 | ||||||||
| Enumeration Date | 2022-05-11 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 175 PETERSBURG, PA 16669-0175 United States Phone: 814-599-0931 | Fax: | ||||||||
| Primary Practice Address | 380 KING STREET PETERSBURG, PA 16669 United States Phone: 814-599-0931 | Fax: | ||||||||
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