Individual
MELLISA LYN QUANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3111 ELECTRIC AVE, PORT HURON, MI 48060-8127
(810) 966-3566
Mailing address
1064 S 15TH ST, SAINT CLAIR, MI 48079-5202
(810) 734-1867
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
—
MI
Other
Enumeration date
02/03/2020
Last updated
07/18/2024
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