Provider Demographics
NPI:1831931393
Name:PROBST, MELISSA KAY (LMBT)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:KAY
Last Name:PROBST
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 S MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-2949
Mailing Address - Country:US
Mailing Address - Phone:828-755-6156
Mailing Address - Fax:
Practice Address - Street 1:431 S MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-2949
Practice Address - Country:US
Practice Address - Phone:828-755-6156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21620225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist