Individual
MELISSA A. MUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAPC
Contact information
Practice address
3633 WHEELER RD, SUITE 365, AUGUSTA, GA 30909-6549
(706) 432-6866
(706) 432-8775
Mailing address
3633 WHEELER RD, SUITE 365, AUGUSTA, GA 30909-6549
(706) 432-6866
(706) 432-8775
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC005496
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APC005496
STATE LICENSE
GA
Enumeration date
12/08/2016
Last updated
12/08/2016
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