Healthcare Provider Details

I. General information

NPI: 1548344310
Provider Name (Legal Business Name): MELISSA J RICE SOCIAL WORKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5145 DOUBLETREE DR
CUMMING GA
30040-9427
US

IV. Provider business mailing address

5145 DOUBLETREE DR
CUMMING GA
30040-9427
US

V. Phone/Fax

Practice location:
  • Phone: 770-889-6817
  • Fax: 770-887-0089
Mailing address:
  • Phone: 770-889-6817
  • Fax: 770-887-0089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: