Provider Demographics
NPI:1053294868
Name:FOLDS, MELISSA DENISE
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:DENISE
Last Name:FOLDS
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 1:1135 TOMAHAWK DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70611-4933
Mailing Address - Country:US
Mailing Address - Phone:225-390-7876
Mailing Address - Fax:
Practice Address - Street 1:5851 GRAY MARKET DR
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-3125
Practice Address - Country:US
Practice Address - Phone:225-390-7876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8313225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist