Provider Demographics
NPI:1548718091
Name:PACIELLO, MELISSA (TCM)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:PACIELLO
Suffix:
Gender:F
Credentials:TCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 LONGLEAF RD
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32926-6449
Mailing Address - Country:US
Mailing Address - Phone:315-749-4772
Mailing Address - Fax:
Practice Address - Street 1:1831 LONGLEAF RD
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32926-6449
Practice Address - Country:US
Practice Address - Phone:315-749-4772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator