Provider Demographics
NPI:1548495559
Name:KORUM, MELANIE ANN (MA)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:ANN
Last Name:KORUM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1822
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80901-1822
Mailing Address - Country:US
Mailing Address - Phone:719-447-9800
Mailing Address - Fax:719-447-1994
Practice Address - Street 1:223 N WAHSATCH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3479
Practice Address - Country:US
Practice Address - Phone:719-447-9800
Practice Address - Fax:719-447-1994
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health