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1275788663
JESSE R MELLOR
WORCESTER, MA
NPI
1275788663
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MA 114)
Enumeration Date
2008-11-26
Last Update Date
2008-11-26
Business Address
Mr. JESSE R MELLOR LADC
44 FRONT ST 490
WORCESTER, MA 01608-1733
Phone number: 508-799-2934
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Mailing Address
Mr. JESSE R MELLOR LADC
119 FOREST ST
WORCESTER, MA 01609-1529
Phone number: 508-799-2934
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