Individual
MELANIE LOCKWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
171 MARSH DEER PL, SURFSIDE BEACH, SC 29575-6204
(843) 550-0252
Mailing address
171 MARSH DEER PL, MYRTLE BEACH, SC 29575-6204
(843) 550-0252
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252Y00000X
—
SC
Enumeration date
08/12/2022
Last updated
08/12/2022
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