Provider Demographics
NPI:1992085872
Name:SAVAGE, MELINDA C
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:C
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 HERITAGE PARK DR STE 1
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0564
Mailing Address - Country:US
Mailing Address - Phone:615-691-5201
Mailing Address - Fax:
Practice Address - Street 1:132 HERITAGE PARK DR STE 1
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0564
Practice Address - Country:US
Practice Address - Phone:615-691-5201
Practice Address - Fax:615-396-8360
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNTIN 20-3858944Medicaid