Healthcare Provider Details

I. General information

NPI: 1699124214
Provider Name (Legal Business Name): MELODY MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2016
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 TOWER DR STE A
MONROE LA
71201-5045
US

IV. Provider business mailing address

2701 STERLINGTON RD APT 116
MONROE LA
71203-2549
US

V. Phone/Fax

Practice location:
  • Phone: 318-570-5400
  • Fax:
Mailing address:
  • Phone: 318-816-2279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPLC11194
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: