Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003244666 |
---|---|
Provider Name | Melissa Bellamy |
First Address | Ocoee, FL 34761-3165 |
Second Address | Ocoee, FL 34761-3165 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2013 |
Last Update Date | 17/10/2013 |