Provider Demographics
NPI:1437478369
Name:MYLES, MELANIE S (PT)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:S
Last Name:MYLES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 MITCHELL AVE
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-4646
Mailing Address - Country:US
Mailing Address - Phone:530-538-7950
Mailing Address - Fax:
Practice Address - Street 1:1072 GRAND AVE
Practice Address - Street 2:APT. A
Practice Address - City:OLIVEHURST
Practice Address - State:CA
Practice Address - Zip Code:95961-7080
Practice Address - Country:US
Practice Address - Phone:805-975-5539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34456167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician