Provider Demographics
NPI:1922829910
Name:BREEN, MELISSA (ACE CPT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BREEN
Suffix:
Gender:F
Credentials:ACE CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 HUTCHESON HALL 0908 250 DRILLFIELD DRIVE
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24061-0001
Mailing Address - Country:US
Mailing Address - Phone:540-231-9347
Mailing Address - Fax:
Practice Address - Street 1:115 HUTCHESON HALL 0908 250 DRILLFIELD DRIVE
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24061-0001
Practice Address - Country:US
Practice Address - Phone:540-231-9347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator