Individual
GEORGIANN MARIE MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYCHOTHERAPIST
Contact information
Practice address
3100 KENNARD ST, MAPLEWOOD, MN 55109-5465
(612) 356-4634
Mailing address
3100 KENNARD ST, MAPLEWOOD, MN 55109-5465
(612) 356-4634
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303142
MN
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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