Individual
MARISSA MELNIKOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W., LSW
Contact information
Practice address
5 BROADWAY, PARK RIDGE, NJ 07656-2105
(845) 461-8232
Mailing address
5 BROADWAY, PARK RIDGE, NJ 07656-2105
(845) 461-8232
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
084008-1
NY
104100000X
Social Worker
Primary
44SL05758100
NJ
Other
Enumeration date
02/23/2016
Last updated
02/23/2016
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