Individual
MELANIE M ECHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1597 PHOENIX BLVD, SUITE 10, COLLEGE PARK, GA 30349-5544
(770) 996-9725
(770) 996-9724
Mailing address
1597 PHOENIX BLVD, SUITE 10, COLLEGE PARK, GA 30349-5544
(770) 996-9725
(770) 996-9724
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002002
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10036639
AMERIGROUP
GA
Enumeration date
02/14/2007
Last updated
07/09/2007
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