Individual
JESSICA MELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
224 THORNCREST DR, PAULINE, SC 29374-1626
(864) 590-0458
Mailing address
194 EVANS RD, EASLEY, SC 29640-7978
(864) 497-4529
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-37207
SC
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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