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Melissa Shane
Mental Health Counselor in Pekin, Illinois
NPI 1639753676

Melissa Shane is a Mental Health Counselor based in Pekin, IL and is specialized in Mental Health. Melissa Shane practices in Pekin, IL. The NPI Number for Melissa Shane is 1639753676 and holds a License No. (Illinois).

The current practice location address for Melissa Shane is 3248 Vandever Ave, Pekin, IL and can be reached out via phone at 309-347-5579.

Location: 3248 Vandever Ave, Pekin, IL, 61554-6274
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Provider Profile Details
NPI Number
1639753676
Provider Name
Melissa Shane
Credential
Provider Entity Type
Individual
Gender
Female
Address
3248 Vandever Ave, Pekin, IL, 61554-6274
Phone Number
309-347-5579
Fax Number
Provider Enumeration Date
05/06/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
101YM0800X 01 TAXONOMY
institution
Provider Business Practice Location Address Details
Address
3248 Vandever Ave
City
State
Zip
61554-6274
Phone Number
309-347-5579
Fax Number
person
Provider Business Mailing Address Details
Address
3248 Vandever Ave
City
State
Zip
61554-6274
Phone Number
309-347-5579
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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