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Individual
MELISSA JAGOE-SEIDL
Active
Individual
MELISSA JAGOE-SEIDL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C1188
OR
101YP2500X
Professional Counselor
Primary
002960
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
03/16/2007
Last updated
07/21/2022
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