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RONALD JERROLD MELVILLE LMSWCC

>> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1750740833

Individual Registrant:
 RONALD JERROLD MELVILLE LMSWCC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
736 OLD LEWISTON RD  WINTHROP, ME 04364-4121 US
Tel: 207-626-3455  Fax: --

Contact information for business:
23 QUAIL RIDGE RD  STANDISH, ME 04084-6481 US
Tel: --  Fax: --

Registration Information:
NPI: 1750740833
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y104100000XBehavioral Health & Social Service Providers
Social Worker
MEMC7110

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BOARD OF SOCIAL WORKER LICENSUREMC7110ME01




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