Provider Demographics
NPI:1194108605
Name:CHOSID, MELISSA (MSMFT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:CHOSID
Suffix:
Gender:F
Credentials:MSMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13610 BARRETT OFFICE DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021-7816
Mailing Address - Country:US
Mailing Address - Phone:314-441-5509
Mailing Address - Fax:
Practice Address - Street 1:13610 BARRETT OFFICE DR
Practice Address - Street 2:SUITE 108
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63021-7816
Practice Address - Country:US
Practice Address - Phone:314-441-5509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist