Most Relevant Information
Provider Data
| NPI Number: | 1003493461 |
| Provider Name: | MELISSA BOYLL LSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | 33009977A |
Most Important Dates
| Enumeration Date: | 03/24/2021 |
| Last Updated: | 03/24/2021 |
Provider Practice Location
1411 LINCOLNWAY W
MISHAWAKA
IN
465441626
Practice Location Phone/Fax
| Phone: | 5745331234 |
| Fax: | 5745372652 |
Provider Mailing Location
PO BOX 809
GOSHEN
IN
465270809
Provider Mailing Phone/Fax
| Phone: | 5745331234 |
| Fax: | 5745372652 |