Healthcare Provider Details

I. General information

NPI: 1497929137
Provider Name (Legal Business Name): MELISSA G BENNETT ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 08/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5755 NORTHPOINT PKWY # 53
ALPHARETTA GA
30022-1142
US

IV. Provider business mailing address

5755 NORTHPOINT PKWY # 53
ALPHARETTA GA
30022-1142
US

V. Phone/Fax

Practice location:
  • Phone: 404-528-9755
  • Fax:
Mailing address:
  • Phone: 404-528-9755
  • Fax: 404-220-9044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: