Individual
MELISSA MICHELLE MELARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14677 MERRILL AVE, FONTANA, CA 92335
(951) 643-2340
Mailing address
14573 EL CONTENTO AVE, FONTANA, CA 92337-0514
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41263
CA
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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