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Individual

MS. REBA J MCMELLON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., LPC

Contact information

Practice address
18601 HIGHWAY 63, MOSS POINT, MS 39562-8579
(228) 588-6143
Mailing address
PO BOX 161, HURLEY, MS 39555-0161
(228) 588-6143

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
498
GA

Other

Enumeration date
08/27/2011
Last updated
08/27/2011
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