Healthcare Provider Details

I. General information

NPI: 1013286079
Provider Name (Legal Business Name): MELANEY THURMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2011
Last Update Date: 11/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

IV. Provider business mailing address

DEPT 781625
DETROIT MI
48278-1625
US

V. Phone/Fax

Practice location:
  • Phone: 614-355-8550
  • Fax: 614-355-8593
Mailing address:
  • Phone: 614-355-8004
  • Fax: 614-355-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.1300679
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: