Doctor Name: | MELINDA CLOUSE |
NPI Number: | 1013048610 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | |
Business Practice Address: | 413 Spring St Chattanooga, TN - 374053848 |
Business Phone Number: | 4237562740 |
Business Fax Number: | |
Mailing Address: | 125 Cavalier Dr # B, COOKEVILLE |
State: | TN |
Postal Code: | 385013658 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/08/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |