Individual
MELANIE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1188 W SPORTSPLEX DR STE 203, KAYSVILLE, UT 84037-6817
(801) 719-7737
(888) 887-9784
Mailing address
2184 CHANNING WAY # 157, IDAHO FALLS, ID 83404-8034
(801) 719-7737
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LCSW-36133
ID
104100000X
Social Worker
LMSW-33744
ID
1041C0700X
Clinical Social Worker
Primary
117243-3501
UT
1041C0700X
Clinical Social Worker
LCSW-36133
ID
Other
Enumeration date
05/12/2014
Last updated
02/23/2022
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