Provider Demographics
NPI:1225545403
Name:MCMINN-MELTON, VICTORIA JADE (MSW)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:JADE
Last Name:MCMINN-MELTON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 VANTAGE WAY STE 400
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1551
Mailing Address - Country:US
Mailing Address - Phone:615-463-6664
Mailing Address - Fax:
Practice Address - Street 1:584 CONGRESS PKWY S
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-2258
Practice Address - Country:US
Practice Address - Phone:423-507-0887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator