Provider Information for 1679818587
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CARRIE M MELTON LMSW
Sex: Female
NPI: 1679818587
Last Updated: 2021-11-24
Certification Date: 2021-11-24
Certification Date: 2021-11-24
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1679818587 | ||||||||||||
| Enumeration Date | 2012-12-04 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 15700 W 10 MILE RD STE 106 SOUTHFIELD, MI 48075-2100 United States Phone: 248-241-6772 | Fax: | ||||||||||||
| Primary Practice Address | 15700 W 10 MILE RD STE 106 SOUTHFIELD, MI 48075-2100 United States Phone: 248-241-6772 | Fax: | ||||||||||||
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