Provider Demographics
NPI:1578258372
Name:MELTON, PILAR DELAINA
Entity Type:Individual
Prefix:
First Name:PILAR
Middle Name:DELAINA
Last Name:MELTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 GOLDEN GATE DR APT G
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-4338
Mailing Address - Country:US
Mailing Address - Phone:704-858-0112
Mailing Address - Fax:
Practice Address - Street 1:2310 GOLDEN GATE DR APT G
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-4338
Practice Address - Country:US
Practice Address - Phone:704-858-0112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician