Individual
MELANY SHAMPO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11902 LAKESIDE DR, FISHERS, IN 46038-1308
(317) 288-5232
Mailing address
11902 LAKESIDE DR, FISHERS, IN 46038-1308
(317) 288-5232
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1107496
IN
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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