Provider Demographics
NPI:1689900896
Name:GARLAND, MELISSA
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:GARLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 MANCHESTER ST
Mailing Address - Street 2:APT. 7
Mailing Address - City:BARBOURVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40906-1758
Mailing Address - Country:US
Mailing Address - Phone:606-546-3152
Mailing Address - Fax:606-546-5057
Practice Address - Street 1:5448 N US HIGHWAY 25E
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:KY
Practice Address - Zip Code:40734-6582
Practice Address - Country:US
Practice Address - Phone:606-546-3152
Practice Address - Fax:606-546-5057
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator