Individual
MELISSA MINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
190 HANDLEY RD STE C, TYRONE, GA 30290-2178
(678) 850-7906
(678) 302-7342
Mailing address
107 INDEPENDENCE DR STE D, WARNER ROBINS, GA 31088-7814
(478) 333-5016
(706) 243-6497
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
20125437
GA
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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