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Individual
MRS. MELANY ROCHELLE FAIRLEY
Active
Individual
MRS. MELANY ROCHELLE FAIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
IMF#95399
CA
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7184
MEDI-CAL
CA
01
—
7368
MEDI-CAL
CA
01
—
7667
MEDI-CAL
CA
01
—
7708
MEDI-CAL
CA
Enumeration date
05/09/2008
Last updated
05/07/2018
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