Provider Demographics
NPI:1174698930
Name:BARLOW, M. MELISSE (MSW)
Entity type:Individual
Prefix:
First Name:M.
Middle Name:MELISSE
Last Name:BARLOW
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:M.
Other - Middle Name:MELISSE
Other - Last Name:DOWNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2050A SECOND ST. SE
Mailing Address - Street 2:
Mailing Address - City:KIRTLAND AFB
Mailing Address - State:NM
Mailing Address - Zip Code:87117-5522
Mailing Address - Country:US
Mailing Address - Phone:505-853-4350
Mailing Address - Fax:
Practice Address - Street 1:2050A SECOND ST. SE
Practice Address - Street 2:
Practice Address - City:KIRTLAND AFB
Practice Address - State:NM
Practice Address - Zip Code:87117-5522
Practice Address - Country:US
Practice Address - Phone:505-853-4350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-25121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical