Provider Demographics
NPI:1871952283
Name:MAHER, MELISSA (LAC)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:MAHER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16350 BLANCO RD STE 110B
Mailing Address - Street 2:C/O BALANCE HEALTH CTR
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16350 BLANCO RD STE 110B
Practice Address - Street 2:C/O BALANCE HEALTH CTR
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3301
Practice Address - Country:US
Practice Address - Phone:210-802-8805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01453171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist