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General NPI Number Information
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NPI Number | 1477853174
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Entity Type | Organization
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Legal Business Name | MELSON COUNSELING AND COUNSULTING GROUP, LLC
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Dates
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Enumeration Date | 10/27/2010
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Last Update Date | 10/27/2010
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Provider Practice Location Address
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Address Line | 2900 CHAMBLEE TUCKER RD BLDG 5-250
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City | ATLANTA
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State | GA
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Zip | 30341-4158
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Country | US
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Telephone | 770-455-7350
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 CHAMBLEE TUCKER RD 5-250
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City | ATLANTA
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State | GA
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Zip | 30341
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Country | US
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Telephone | 770-455-7350
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. PATRICIA L MELSON
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Credential |
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Telephone | 678-938-9841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 004455
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License Number State | GA
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