Individual
MELISA RAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
3303 S LINDSAY RD, GILBERT, AZ 85297-1503
(480) 239-2479
Mailing address
PO BOX 7203, CHANDLER, AZ 85246
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-12226
AZ
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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