MEDICARE: MELODY R LUMPKIN

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
1	251C00000X	Developmentally Disabled Services Day Training Agency	591550159ML	OH
2	251C00000X	Developmentally Disabled Services Day Training Agency	5915550159	OH

General Provider Information

NPI Number	:	1336987429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELODY R LUMPKIN

Provider Business Mailing Address
First Line	:	3080 MCHENRY AVE APT 33
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-7366
Country	:	US
Telephone Number	:	513-675-5369
Fax Number	:

Provider Business Practice Location Address
First Line	:	3080 MCHENRY AVE APT 33
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-7366
Country	:	US
Telephone Number	:	513-675-5369
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2024
Last Update Date	:	07/15/2024

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Directions to “ MELODY R LUMPKIN ” Practice Location

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