Provider Demographics
NPI:1063195485
Name:ST PETER, MELISSA FAITH
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:FAITH
Last Name:ST PETER
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 1:30 E WASHINGTON ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:HANSON
Mailing Address - State:MA
Mailing Address - Zip Code:02341-1126
Mailing Address - Country:US
Mailing Address - Phone:207-974-6047
Mailing Address - Fax:
Practice Address - Street 1:30 E WASHINGTON ST UNIT 2
Practice Address - Street 2:
Practice Address - City:HANSON
Practice Address - State:MA
Practice Address - Zip Code:02341-1126
Practice Address - Country:US
Practice Address - Phone:207-974-6047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist