Individual
MR. JESSE R MELLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
44 FRONT ST, 490, WORCESTER, MA 01608-1733
(508) 799-2934
(508) 770-1732
Mailing address
119 FOREST ST, WORCESTER, MA 01609-1529
(508) 799-2934
(508) 770-1732
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
114
MA
Other
Enumeration date
11/26/2008
Last updated
11/26/2008
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