Individual
MELINDA RENEE CAUDILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
80 BLUE JAY CT, VINE GROVE, KY 40175-6289
(606) 776-2536
Mailing address
80 BLUE JAY CT, VINE GROVE, KY 40175-6289
(606) 776-2536
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
KY
Other
Enumeration date
09/26/2025
Last updated
10/24/2025
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