Individual
TANYA V KAVICKY-MELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
301 E SAINT JOSEPH ST, GREEN BAY, WI 54301-2241
(920) 433-3630
(920) 437-0533
Mailing address
PO BOX 22040, GREEN BAY, WI 54305-2040
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1086-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891057303
—
CA
Enumeration date
06/11/2012
Last updated
07/21/2022
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