Individual
JESSICA MELVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
207 NE 7TH ST, GRANGEVILLE, ID 83530-1847
(253) 709-3647
Mailing address
PO BOX 40, STITES, ID 83552-0040
(253) 709-3647
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
38103
ID
Other
Enumeration date
01/25/2019
Last updated
01/25/2019
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