Basic Information
Provider Information
NPI: 1598131732
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DECHANT
FirstName: MELISSA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: BSRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8931 HURON ST
Address2:  
City: THORNTON
State: CO
PostalCode: 802606806
CountryCode: US
TelephoneNumber: 3038533500
FaxNumber: 3032804003
Practice Location
Address1: 8931 HURON ST
Address2:  
City: THORNTON
State: CO
PostalCode: 802606806
CountryCode: US
TelephoneNumber: 3038533500
FaxNumber: 3032804003
Other Information
ProviderEnumerationDate: 08/11/2015
LastUpdateDate: 08/11/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0808XRN.0203719COY Nursing Service ProvidersRegistered NursePsych/Mental Health

No ID Information.


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