Individual
MS. AMY ELIZABETH MELLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
311 RAMSEY ST., SUITE 205, ST. PAUL, MN 55102
(651) 262-9726
(651) 294-2347
Mailing address
1137 SEMINARY AVE., ST. PAUL, MN 55104
(651) 262-9726
(651) 294-2347
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
17145
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09B85ME
BCBS OF MN
MN
05
—
221928100
—
MN
01
—
HP88034
HEALTH PARTNERS
MN
Enumeration date
12/10/2007
Last updated
03/28/2012
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