Individual
MELODYE JILL HORNISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
RR 1 BOX 96A, HARRISVILLE, WV 26362-9719
(304) 869-3763
(304) 869-3763
Mailing address
PO BOX 234, ELLENBORO, WV 26346-0234
(304) 869-3763
(304) 869-3763
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
813
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9202089000
—
WV
Enumeration date
05/01/2006
Last updated
07/08/2007
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