Wallace, Melissa M.

Wallace, Melissa M. is an individual health care provider with primary practice located at 250 Commercial Street Suite 3004, Manchester NH 03101-1118. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Wallace, Melissa M. can be contacted via phone (603) 668-3050.

Contact Information

Primary practice address
250 Commercial Street Suite 3004 Manchester NH 03101-1118
Phone: (603) 668-3050
Fax: (603) 668-8666
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1165 New Hampshire

Profile Details

NPI number 1235216482
LBN Legal business name Wallace, Melissa M.
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Aug 13th, 2014 - about 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1235216482 NPPES
New Hampshire MEDICAID 3080928

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