Individual
MELISSA ANN CERECERES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, LMFT-A
Contact information
Practice address
4534 W GATE BLVD, AUSTIN, TX 78745-1485
(512) 773-6164
(512) 519-4232
Mailing address
PO BOX 685202, AUSTIN, TX 78768-5202
(512) 773-6164
(512) 519-4232
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
201578
TX
163W00000X
Registered Nurse
781480
TX
Other
Enumeration date
07/13/2010
Last updated
07/13/2010
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