Individual
MELISSA TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10640 BUSINESS 21, HILLSBORO, MO 63050-5039
(618) 877-4420
Mailing address
1085 MAPLE ST, FARMINGTON, MO 63640-1955
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2017038564
MO
101YM0800X
Mental Health Counselor
Primary
2017038564
MO
101YP2500X
Professional Counselor
2017038564
MO
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
12/09/2013
Last updated
11/13/2023
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