Individual
MARISSA LYNN MELLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
631 S COLLEGE AVE, NEWARK, DE 19716-2010
(302) 831-4006
Mailing address
25 HEATHCOTE AVE, EDISON, NJ 08817-4732
(732) 570-4229
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
RESPIRATORY, REHABILITATIVE, RESTORATIVE SERVICE PROVIDERS
DE
Enumeration date
02/08/2023
Last updated
02/08/2023
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