MELINDA ANNETTE GREEN NPI 1063010676

NPI Information

  • NPI: 1063010676
  • Provider Name: MELINDA ANNETTE GREEN
  • Classification: Clinic/Center - 261QD1600X
  • Specialization: Developmental Disabilities
  • Entity Type: Individual
  • Address: 22 MEADOWBROOK AVE
    BOARDMAN, OH
    ZIP 44512
  • Phone: (330) 774-4670

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NPI Details

Melinda Annette Green is a developmental disabilities clinic center in Boardman, OH. The provider is an entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). Melinda Annette Green NPI is 1063010676. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

22 MEADOWBROOK AVE
BOARDMAN, OH
ZIP 44512-605
Phone: (330) 774-4670

The enumeration date for this NPI number is 10/15/2020 and was last updated on 10/15/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD1600XClinic/CenterDevelopmental DisabilitiesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15505995MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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