Individual
MELONIE A BEATTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12133 BROOKVIEW DR, MIDLOTHIAN, VA 23112-2931
(804) 301-3178
Mailing address
12133 BROOKVIEW DR, MIDLOTHIAN, VA 23112-2931
(804) 301-3178
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0175172615
—
VA
Enumeration date
04/24/2018
Last updated
04/24/2018
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