Provider Demographics
NPI:1548366495
Name:MELLAND, JANICE
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:MELLAND
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 1:719 MASSACHUSETTS ST
Mailing Address - Street 2:STE127
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:719 MASSACHUSETTS ST
Practice Address - Street 2:STE127
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2345
Practice Address - Country:US
Practice Address - Phone:785-865-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical