Provider Demographics
NPI:1649640368
Name:COX, MELINDA KAY
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:KAY
Last Name:COX
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 1:382 WASHAKIE
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520
Mailing Address - Country:US
Mailing Address - Phone:307-349-2990
Mailing Address - Fax:
Practice Address - Street 1:382 WASHAKIE
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520
Practice Address - Country:US
Practice Address - Phone:307-349-2990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services