Individual
MRS. MELANIE JEANNINE JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
248 GENEVA BLVD, MADISON, MS 39110-7739
(601) 260-7793
Mailing address
248 GENEVA BLVD, MADISON, MS 39110-7739
(601) 260-7793
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
TA1800
MS
Other
Enumeration date
07/31/2011
Last updated
07/31/2011
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