Provider Demographics
NPI:1063603090
Name:GALLIMORE, MELANIE A (MA)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:A
Last Name:GALLIMORE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 WALNUT BEND RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-4010
Mailing Address - Country:US
Mailing Address - Phone:901-827-0440
Mailing Address - Fax:
Practice Address - Street 1:7410 MEMPHIS ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38135-1908
Practice Address - Country:US
Practice Address - Phone:901-252-7859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health