Individual
MELISSA RAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1579 WILLOW DR, MARIETTA, GA 30066-1244
(718) 501-9143
(678) 302-7017
Mailing address
1579 WILLOW DR, MARIETTA, GA 30066-1244
(678) 494-5921
(678) 302-7017
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003127350A
—
GA
Enumeration date
08/15/2013
Last updated
08/15/2013
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