Individual
TRACI MELLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
1440 RUSSELL RD, PAOLI, PA 19301-1236
(610) 644-6464
(610) 644-4066
Mailing address
1440 RUSSELL RD, PAOLI, PA 19301-1236
(610) 644-6464
(610) 644-4066
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/08/2007
Last updated
11/08/2007
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