Provider Demographics
NPI:1154533081
Name:ROTKIEWICZ, MELISSA (PHD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ROTKIEWICZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 INFIRMARY WAY
Mailing Address - Street 2:127 HILLS NORTH
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01003-9287
Mailing Address - Country:US
Mailing Address - Phone:413-545-2337
Mailing Address - Fax:413-545-9602
Practice Address - Street 1:111 INFIRMARY WAY
Practice Address - Street 2:127 HILLS NORTH
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01003-9287
Practice Address - Country:US
Practice Address - Phone:413-545-2337
Practice Address - Fax:413-545-9602
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8530103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist