Provider Demographics
NPI:1902422736
Name:ASIAMAH, MELINDA
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:
Last Name:ASIAMAH
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 1:4 FRANK LEARY WAY UNIT 4
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4512
Mailing Address - Country:US
Mailing Address - Phone:781-885-7530
Mailing Address - Fax:
Practice Address - Street 1:966 PARK ST STE 2
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-3650
Practice Address - Country:US
Practice Address - Phone:781-885-7530
Practice Address - Fax:855-284-1305
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA414866101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health