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Individual

MRS. WENDY YESENIA MELO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1421 TUSCAN DR, FUQUAY VARINA, NC 27526-5376
(919) 285-4182
Mailing address
1421 TUSCAN DR, FUQUAY VARINA, NC 27526-5376
(919) 285-4182

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
222Q00000X
Developmental Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
767626300
FL
05
811928700
FL
Enumeration date
09/12/2006
Last updated
05/01/2009
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