| Doctor Name: | MELISSA SOUTH |
| NPI Number: | 1821499609 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.C.S.W. |
| License Number: | 0904008712 |
| Business Practice Address: | 129 Bowden St Saluda, VA - 23149 |
| Business Phone Number: | 8047584035 |
| Business Fax Number: | 8046958122 |
| Mailing Address: | Po Box 40, SALUDA |
| State: | VA |
| Postal Code: | 231490040 |
| Phone Number: | 8047584035 |
| Fax Number: | 8046958122 |
| NPI Enumeration Date: | 09/11/2014 |
| NPI Last Update Date: | 09/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 0904008712 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |