Provider Information for 1730648270
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MELISSA SUE SUTTON MA LPC
Other Names:Former Name:MELISSA SUE RUSSELL MA ALCSex: Female
NPI: 1730648270
Last Updated: 2021-07-27
Certification Date: 2021-07-08
Certification Date: 2021-07-08
Details
| Name | Value | ||||||||
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| NPI | 1730648270 | ||||||||
| Enumeration Date | 2019-03-14 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6900 HIGHWAY 81 PHIL CAMPBELL, AL 35581-6030 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 401 4TH AVE S JASPER, AL 35501-3705 United States Phone: 205-530-3358 | Fax: | ||||||||
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