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Individual
MELISSA TACY ILLARIO
Active
Individual
MELISSA TACY ILLARIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
121960
CA
1041C0700X
Clinical Social Worker
12877651-3501
UT
Other
Enumeration date
04/25/2019
Last updated
04/15/2026
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