Healthcare Provider Details

I. General information

NPI: 1700661238
Provider Name (Legal Business Name): MELISSA JANE SPOONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SCHOOL DR STE D
THOMASVILLE NC
27360-6330
US

IV. Provider business mailing address

201 SCHOOL DR STE D
THOMASVILLE NC
27360-6330
US

V. Phone/Fax

Practice location:
  • Phone: 336-475-1362
  • Fax: 336-475-1363
Mailing address:
  • Phone: 336-475-1362
  • Fax: 336-475-1363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberC020417
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: