Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | MD |
NPI | 1295358307 |
---|---|
Provider Name | Vincent Anthony Melanson |
First Address | Baltimore, MD 21212-4101 |
Second Address | Baltimore, MD 21212-4101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2020 |
Last Update Date | 22/05/2020 |