Individual
MELONY LEE MICHEALS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4200 WEDGEWOOD LN N, PLYMOUTH, MN 55442-2645
(612) 385-1914
Mailing address
4200 WEDGEWOOD LN N, PLYMOUTH, MN 55442-2645
(612) 385-1914
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
1123115
MN
Other
Enumeration date
03/25/2025
Last updated
03/25/2025
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