Individual
MAKENZIE MELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
239 GOLDEN HILL LN, KINGSTON, NY 12401-6452
(845) 702-1317
Mailing address
PO BOX 113, MODENA, NY 12548-0113
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
33725
NY
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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