Healthcare Provider Details

I. General information

NPI: 1457279390
Provider Name (Legal Business Name): MELISSA KUD DAC, LAC,LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 N KENMORE ST APT 1
ARLINGTON VA
22201-2226
US

IV. Provider business mailing address

923 N KENMORE ST APT 1
ARLINGTON VA
22201-2226
US

V. Phone/Fax

Practice location:
  • Phone: 703-963-4257
  • Fax:
Mailing address:
  • Phone: 703-963-4257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0121001018
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0019018302
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: