Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 63480 | TX |
NPI | 1003109679 |
---|---|
Provider Name | Mrs. Melissa Diane Barton |
First Address | Meadows Place, TX 77477-1502 |
Second Address | Katy, TX 77493-1914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2011 |
Last Update Date | 22/05/2012 |