Individual
ANGELA MELLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
212 NORTH COURT STREET, WAYNE, WV 25570
(304) 529-6205
(304) 529-6209
Mailing address
212 NORTH COURT STREET, WAYNE, WV 25570
(304) 529-6205
(304) 529-6209
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
F362604
WV
Other
Enumeration date
11/01/2013
Last updated
11/01/2013
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