Individual
MELISSA K PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHP
Contact information
Practice address
237 26TH ST, OGDEN, UT 84401-3105
(801) 625-3700
Mailing address
237 26TH ST, OGDEN, UT 84401-3105
(801) 625-3700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CG60318795
WA
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260022408
RAILROAD MEDICARE
UT
05
—
876000308007
—
UT
Enumeration date
10/16/2012
Last updated
04/11/2014
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