Individual provider · NPI-1

Melissa Annette Leach

Technician, Other, EEG · Marietta, GA

NPI number1093492993
StatusActive
Last updated in NPPESJul 3, 2023

Details

NPI
1093492993
Entity type
Individual (NPI-1)
Name
Melissa Annette Leach
Sex
Female
Sole proprietor
Yes
Enumeration date
Jul 3, 2023
Certification date
Jul 1, 2023
Last updated
Jul 3, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2472E0500X Technician, Other, EEG––Yes

Practice location

1380 Wylie Dr Se
Marietta, GA 30067-7536

Phone 770-485-1855

Mailing address

1380 Wylie Dr Se
Marietta, GA 30067-7536

Phone 770-485-1855

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