Healthcare Provider Details

I. General information

NPI: 1972871739
Provider Name (Legal Business Name): MELISSA MARIE HALL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA MARIE CRAMPTON

II. Dates (important events)

Enumeration Date: 12/08/2011
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 MEMORIAL DR
CLARKSVILLE TN
37043-6326
US

IV. Provider business mailing address

4513 OLD CLARKSVILLE PIKE
CLARKSVILLE TN
37043-7922
US

V. Phone/Fax

Practice location:
  • Phone: 931-920-7300
  • Fax:
Mailing address:
  • Phone: 931-542-8188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: