Individual
LISA MELENDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
82 S BALTIC PL, MERIDIAN, ID 83642-5935
(732) 272-8187
Mailing address
709 W BRIDGER AVE, NAMPA, ID 83651-1944
(732) 272-8187
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LMSW-41110
ID
1041C0700X
Clinical Social Worker
Primary
41110
ID
Other
Enumeration date
09/09/2021
Last updated
08/01/2024
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