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NPI Code Detail

MEDICARE: ZANA ZYQUISHA MELVIN

MEDICARE: ZANA ZYQUISHA MELVIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-20-134901GA

General Provider Information

NPI Number : 1194330605
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZANA ZYQUISHA MELVIN
Provider Business Mailing Address
First Line : 740 E GENERAL STEWART WAY STE 202B
Second Line :
City : HINESVILLE
State : GA
Zip : 31313-2630
Country : US
Telephone Number : 912-294-4055
Fax Number : 866-467-4321
Provider Business Practice Location Address
First Line : 740 E GENERAL STEWART WAY STE 202B
Second Line :
City : HINESVILLE
State : GA
Zip : 31313-2630
Country : US
Telephone Number : 912-294-4055
Fax Number : 866-467-4321
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2020
Last Update Date : 09/11/2020

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Directions to “ ZANA ZYQUISHA MELVIN ” Practice Location

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