Individual
MELISSA GILLENWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27 FRANKLIN ST, SPRINGVILLE, NY 14141-1375
(716) 592-9301
(716) 592-9376
Mailing address
227 THORN AVE, ORCHARD PARK, NY 14127-2600
(716) 662-2040
(716) 662-0019
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CRPA-P-6673
NY
175T00000X
Peer Specialist
—
—
Other
Enumeration date
04/13/2023
Last updated
07/14/2023
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