Provider Demographics
NPI:1366929077
Name:DAILEY, MELANIE (LAC)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:
Last Name:DAILEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 E HIGH ST # 208-A
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40507-1938
Mailing Address - Country:US
Mailing Address - Phone:859-813-4208
Mailing Address - Fax:
Practice Address - Street 1:465 E HIGH ST STE 208A
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507
Practice Address - Country:US
Practice Address - Phone:859-813-4208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-25
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAC124171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist