Provider Demographics
NPI:1659645018
Name:MELANEE DAVIS
Entity Type:Organization
Organization Name:MELANEE DAVIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMP BEHAVIORAL ASSESSOR
Authorized Official - Prefix:
Authorized Official - First Name:MELANEE
Authorized Official - Middle Name:ALICEA
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-512-2192
Mailing Address - Street 1:14221 SW 48TH COURT RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34473-2384
Mailing Address - Country:US
Mailing Address - Phone:352-512-2192
Mailing Address - Fax:
Practice Address - Street 1:14221 SW 48TH COURT RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34473-2384
Practice Address - Country:US
Practice Address - Phone:352-512-2192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health