Individual
THERESA ELLEN MELLOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1898 CALHOUN ST, BUILDING 5, COLUMBIA, SC 29201-2649
(803) 233-9174
(803) 233-2814
Mailing address
1898 CALHOUN ST, BUILDING 5, COLUMBIA, SC 29201-2649
(803) 807-2356
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
616
SC
Other
Enumeration date
09/21/2006
Last updated
12/20/2021
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