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Melrose Mona Ellan Mask, PSS
Peer Specialist in Roseburg, Oregon
NPI 1871128215

Melrose Mona Ellan Mask is a Peer Specialist based in Roseburg, OR. Melrose Mona Ellan Mask practices in Roseburg, OR and has the professional credentials of PSS. The NPI Number for Melrose Mona Ellan Mask is 1871128215 and holds a License No. THW000004127 (Oregon).

The current practice location address for Melrose Mona Ellan Mask is 621 W Madrone St, Roseburg, OR and can be reached out via phone at 541-672-2691.

Location: 621 W Madrone St, Roseburg, OR, 97470-0254
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871128215
Provider Name
Melrose Mona Ellan Mask
Credential
PSS
Provider Entity Type
Individual
Gender
Female
Address
621 W Madrone St, Roseburg, OR, 97470-0254
Phone Number
541-672-2691
Fax Number
Provider Enumeration Date
03/05/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
621 W Madrone St
City
Roseburg
State
Oregon
Zip
97470-3090
Phone Number
541-672-2691
Fax Number
person
Provider Business Mailing Address Details
Address
621 W Madrone St
City
Roseburg
State
Oregon
Zip
97470-3090
Phone Number
541-672-2691
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
THW000004127 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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