Individual
SANTE MELAKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
180 CENTRE ST, BROCKTON, MA 02302-2733
(508) 502-7584
Mailing address
180 CENTRE ST, BROCKTON, MA 02302-2733
(508) 502-7584
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YA0400X
—
MA
Enumeration date
07/13/2018
Last updated
07/13/2018
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