Individual
MRS. MELENA OUTLAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
457 BENTLEY LOOP, JENKINS, KY 41537-9004
(606) 832-1473
(606) 832-0397
Mailing address
PO BOX 1403, JENKINS, KY 41537-1403
(606) 832-1473
(606) 832-0397
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
03/05/2007
Last updated
10/15/2014
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