Individual
MELISSA MATHEWS
Active
Individual
MELISSA MATHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
129920
KY
103G00000X
Clinical Neuropsychologist
2012-52
KY
103G00000X
Clinical Neuropsychologist
3366
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235339151
NPI NUMBER
—
01
—
12405591
CAQH PROVIDER ID
KY
Enumeration date
07/19/2007
Last updated
04/03/2018
Update your record
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