Individual
MELISSA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 THUNDERSTICK DR, LEXINGTON, KY 40505-9010
(859) 254-1035
Mailing address
2250 THUNDERSTICK DR, LEXINGTON, KY 40505-9010
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
270795565
KY
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922435791
—
KY
Enumeration date
10/10/2013
Last updated
06/16/2018
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