Sample, Melina Marie
Sample, Melina Marie is an sole proprietor health care provider with primary practice located at 210 S Race St , Mishawaka IN 46544-2032. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Sample, Melina Marie can be contacted via phone (574) 404-6755.Contact Information
Primary practice address
210 S Race St
Mishawaka IN 46544-2032
Phone: (574) 404-6755
Fax: (833) 783-4269
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 20043242A | Indiana |
Profile Details
| NPI number | 1861049595 |
|---|---|
| LBN Legal business name | Sample, Melina Marie |
| Credentials | PHD, HSPP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 19th, 2019 |
| Last updated | Aug 19th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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