Provider Demographics
NPI:1780030528
Name:HUEY, MELINDA MARIE (LAT, ATC)
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:MARIE
Last Name:HUEY
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 BUENA VIS
Mailing Address - Street 2:
Mailing Address - City:EMLENTON
Mailing Address - State:PA
Mailing Address - Zip Code:16373-9702
Mailing Address - Country:US
Mailing Address - Phone:814-860-1813
Mailing Address - Fax:
Practice Address - Street 1:420 BUENA VIS
Practice Address - Street 2:
Practice Address - City:EMLENTON
Practice Address - State:PA
Practice Address - Zip Code:16373-9702
Practice Address - Country:US
Practice Address - Phone:814-860-1813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART006362246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other