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Individual

MELISSA MATHEWS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D

Contact information

Practice address
1300 CAMPBELL LN, BOWLING GREEN, KY 42104-4162
(270) 287-8134
Mailing address
224 MARK TRL, BOWLING GREEN, KY 42101-9257

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
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