Individual
MIRANDA REBECCA MELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7617 CHAMPLAIN DR, WILMINGTON, NC 28412-2677
(252) 481-1909
Mailing address
7617 CHAMPLAIN DR, WILMINGTON, NC 28412-2677
(252) 481-1909
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1144156
NC
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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