Provider Demographics
NPI:1902833478
Name:MCMAHAN, MELISSA LEIGH (MHP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:LEIGH
Last Name:MCMAHAN
Suffix:
Gender:F
Credentials:MHP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6430
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72766-6430
Mailing Address - Country:US
Mailing Address - Phone:479-750-2020
Mailing Address - Fax:479-524-5197
Practice Address - Street 1:710 S HOLLY ST
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-3304
Practice Address - Country:US
Practice Address - Phone:479-750-2020
Practice Address - Fax:479-524-5197
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS