Individual
NICOLE MARIE MELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
69 BARREL HORSE DR, CHARLES TOWN, WV 25414-9489
(609) 744-2604
Mailing address
69 BARREL HORSE DR, CHARLES TOWN, WV 25414-9489
(609) 744-2604
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
WV
Other
Enumeration date
08/28/2025
Last updated
08/28/2025
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