Randolph, Melanie

Randolph, Melanie is an individual health care provider with primary practice located at 380 Suwannee Trail St , Bowling Green KY 42103-7956. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Randolph, Melanie can be contacted via phone (270) 901-5000.

Contact Information

Primary practice address
380 Suwannee Trail St Bowling Green KY 42103-7956
Phone: (270) 901-5000
Fax: (270) 842-5268
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 06-0042 Kentucky

Profile Details

NPI number 1477829075
LBN Legal business name Randolph, Melanie
Credentials MAE, MFTA
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2012
Last updated Mar 28th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477829075 NPPES
Kentucky MEDICAID 30604011

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