Most Relevant Information
Provider Data
| NPI Number: | 1003358185 |
| Provider Name: | MELODY RAY BCBA, LMHC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | MH14594 |
Most Important Dates
| Enumeration Date: | 11/07/2016 |
| Last Updated: | 11/07/2016 |
Provider Practice Location
350 HOLLYWOOD BLVD SE
FORT WALTON BEACH
FL
325485772
Practice Location Phone/Fax
| Phone: | 8503689373 |
| Fax: |
Provider Mailing Location
350 HOLLYWOOD BLVD SE
FORT WALTON BEACH
FL
325485772
Provider Mailing Phone/Fax
| Phone: | 8503689373 |
| Fax: |