Provider Demographics
NPI:1780425199
Name:OWENS, MELISSA DOLGETTA (INHC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:DOLGETTA
Last Name:OWENS
Suffix:
Gender:F
Credentials:INHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1739 W NANCY CREEK DR NE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-1745
Mailing Address - Country:US
Mailing Address - Phone:404-936-4460
Mailing Address - Fax:
Practice Address - Street 1:1739 W NANCY CREEK DR NE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-1745
Practice Address - Country:US
Practice Address - Phone:404-936-4460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty