Provider Demographics
NPI:1366058810
Name:RICHARDS, MELE
Entity type:Individual
Prefix:
First Name:MELE
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 STOVER DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW MATAMORAS
Mailing Address - State:OH
Mailing Address - Zip Code:45767
Mailing Address - Country:US
Mailing Address - Phone:304-771-6818
Mailing Address - Fax:
Practice Address - Street 1:804 STOVER DRIVE
Practice Address - Street 2:
Practice Address - City:NEW MATAMORAS
Practice Address - State:OH
Practice Address - Zip Code:45767
Practice Address - Country:US
Practice Address - Phone:304-771-6818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant