Provider Demographics
NPI:1134683212
Name:PERDUE-MELTON, DANNA (ALC)
Entity Type:Individual
Prefix:
First Name:DANNA
Middle Name:
Last Name:PERDUE-MELTON
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 14TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-4906
Mailing Address - Country:US
Mailing Address - Phone:205-933-0338
Mailing Address - Fax:205-933-0343
Practice Address - Street 1:1900 14TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-4906
Practice Address - Country:US
Practice Address - Phone:205-933-0338
Practice Address - Fax:205-933-0343
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health