Individual
MELODY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCSH
Contact information
Practice address
100 PROFESSIONAL PL STE 307, CARROLLTON, GA 30117-3872
(770) 812-5977
(770) 812-5981
Mailing address
126 LAKEVIEW DR, TEMPLE, GA 30179-3708
(678) 988-0705
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
263
GA
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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