Organization
MINDFUL LEGACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHEKILA S MELCHIOR LPC (LICENSED PROFESSIONAL COUNSELOR)
(336) 301-9765
Entity
Organization
Contact information
Practice address
4229 JEFFERSON OAKS CIR APT B, FAIRFAX, VA 22033-4071
(703) 718-6413
Mailing address
12587 FAIR LAKES CIR # 406, FAIRFAX, VA 22033-3822
(336) 301-9765
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/02/2023
Last updated
12/11/2023
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