Individual
MELISHA IVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3780 NORTHSIDE DR STE 140, MACON, GA 31210-2436
(478) 703-6938
Mailing address
3780 NORTHSIDE DR STE 140, MACON, GA 31210-2436
(478) 703-6938
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
012020
GA
Other
Enumeration date
10/01/2021
Last updated
01/21/2025
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