Individual
CAROLINE MELLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
17505 N 79TH AVE STE 105, GLENDALE, AZ 85308-8724
(602) 989-8899
Mailing address
17505 N 79TH AVE STE 105, GLENDALE, AZ 85308-8724
(602) 989-8899
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CSLG13230
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043982747
ARROWHEAD NPI
AZ
01
—
1740851542
JANUARY HARTZE INDIVIDUAL NPI
AZ
01
—
1801623228
CENTERPOINTE NPI
AZ
05
—
180298
—
AZ
05
—
203827
—
AZ
Enumeration date
02/18/2025
Last updated
02/18/2025
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