Organization
MELODY BLACK LLC
Active
Other names
Heart Matters
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELODY BLACK L.P.C. (PROFESSIONAL COUNSELOR)
(770) 789-0274
Entity
Organization
Contact information
Practice address
823 RIDGEFIELD DR, PEACHTREE CITY, GA 30269-2510
(770) 789-0274
(086) 658-8441
Mailing address
823 RIDGEFIELD DR, PEACHTREE CITY, GA 30269-2510
(770) 789-0274
(086) 658-8441
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
006648
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003119695A
—
GA
Enumeration date
06/29/2012
Last updated
06/29/2012
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