Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003185091 |
---|---|
Provider Name | Mrs. Aleta Mello |
First Address | New Bedford, MA 02740-5716 |
Second Address | New Bedford, MA 02740-5716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2011 |
Last Update Date | 20/12/2011 |