Individual
MELISSA ANN MAAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD LP
Contact information
Practice address
1125 6TH ST SE, WILLMAR, MN 56201-4675
(320) 235-4613
(320) 235-9384
Mailing address
1125 6TH ST SE, PO BOX 787, WILLMAR, MN 56201-4675
(320) 235-4613
(320) 235-9384
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4776
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
049N3PA
BCBS
—
01
—
152220
BHP U CARE
—
05
—
523975100
—
MN
01
—
HP78777
HEALTH PARTNERS
—
Enumeration date
01/26/2007
Last updated
10/31/2016
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