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Organization

DR. MELITA PSYCHOLOGICAL SERVICES, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MELITA THAIS PSYCHOLOGICAL L,PSYCH PHD (CLINICAL PSYCHOLOGIST)
(803) 467-9628
Entity
Organization

Contact information

Practice address
515 MADISON AVE FL 21, NEW YORK, NY 10022-5433
(917) 336-1673
Mailing address
555 MADISON AVE FL 5, NEW YORK, NY 10022-3410
(917) 336-1673

Taxonomy

Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary

Other

Enumeration date
09/25/2020
Last updated
09/25/2020
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