Provider Demographics
NPI:1891014106
Name:BERRY, MELANIE (MS, BCB)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:
Last Name:BERRY
Suffix:
Gender:F
Credentials:MS, BCB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6439 GARNERS FERRY RD
Mailing Address - Street 2:3W PAIN CENTER
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-1638
Mailing Address - Country:US
Mailing Address - Phone:803-116-4000
Mailing Address - Fax:803-647-5777
Practice Address - Street 1:6439 GARNERS FERRY RD
Practice Address - Street 2:3W PAIN CENTER
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-1638
Practice Address - Country:US
Practice Address - Phone:803-116-4000
Practice Address - Fax:803-647-5777
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other