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Individual

MS. GAIL DENISE MELPOLDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COMS, CLVT, CRC

Contact information

Practice address
6 FAWN LN, LA LUZ, NM 88337-9339
(575) 415-2008
(888) 453-1138
Mailing address
6 FAWN LN, LA LUZ, NM 88337-9339
(575) 415-2008
(888) 453-1138

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
00016215 CRCC
174400000X
Specialist
Primary
4815 - ACVREP
174400000X
Specialist
5622 ACVREP

Other

Enumeration date
02/07/2010
Last updated
02/07/2010
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