Individual
MELISSA SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8388
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8388
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
65897
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
65897
LCSW
TX
Enumeration date
07/27/2010
Last updated
03/22/2023
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