Individual
MELISSA BOULDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
90 HOWARD DR, SHELBYVILLE, KY 40065-8138
(502) 633-1007
Mailing address
90 HOWARD DR, SHELBYVILLE, KY 40065-8138
(502) 633-1007
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
170807
KY
Other
Enumeration date
10/29/2018
Last updated
03/01/2019
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