Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 120501 | MA |
NPI | 1255819090 |
---|---|
Provider Name | Kacie Dawn Melo |
First Address | Haverhill, MA 01835 |
Second Address | Billerica, MA 01821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2018 |
Last Update Date | 03/08/2018 |