Individual
DR. MELISSA LEA WOODSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
5007 LAVENDER LEAF, LONGVIEW, TX 75604-0600
(903) 759-1043
(903) 759-0897
Mailing address
5007 LAVENDER LEAF, LONGVIEW, TX 75604-0600
(903) 759-1043
(903) 759-0897
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
32583
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177695701
—
TX
01
—
P00315110
RAILROAD MEDICARE
TX
Enumeration date
09/03/2006
Last updated
07/08/2007
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