Individual
MELISSA JEAN BANTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10084 E STATE ROAD 54, BLOOMFIELD, IN 47424-6063
(507) 703-3512
Mailing address
10084 E STATE ROAD 54, BLOOMFIELD, IN 47424-6063
(507) 703-3512
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4573
MN
Other
Enumeration date
10/12/2021
Last updated
11/17/2025
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