Provider Demographics
NPI:1245044692
Name:MCNALLY, MELANIE A (C-IAYT)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:A
Last Name:MCNALLY
Suffix:
Gender:F
Credentials:C-IAYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 MILL RUN DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-2861
Mailing Address - Country:US
Mailing Address - Phone:404-421-5460
Mailing Address - Fax:
Practice Address - Street 1:5330 MILL RUN DR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2861
Practice Address - Country:US
Practice Address - Phone:404-421-5460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA75877205171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach