Individual
MELLANIE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1950 HAGGARD CT, LEXINGTON, KY 40505-1534
(859) 447-2309
Mailing address
1950 HAGGARD CT, LEXINGTON, KY 40505-1534
(859) 447-2309
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
26-522242
KY
Other
Enumeration date
08/03/2026
Last updated
08/03/2026
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