Healthcare Provider Details

I. General information

NPI: 1770419921
Provider Name (Legal Business Name): MELISSA ADKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 HASTY ST
MARSHVILLE NC
28103-1287
US

IV. Provider business mailing address

945 N CENTRAL AVE
WOODMERE NY
11598-1604
US

V. Phone/Fax

Practice location:
  • Phone: 704-935-6218
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number26530417
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: