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Individual
MELVA JEANNETTE PENNE
Active
Individual
MELVA JEANNETTE PENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, NCC, CGACII
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
G 08-04-06
OR
101YM0800X
Mental Health Counselor
NCC-201117
—
101YP2500X
Professional Counselor
C1987
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100113
AMISYS ID
AZ
05
—
970758
—
AZ
Enumeration date
09/08/2006
Last updated
03/15/2011
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