Individual
DR. MELODY ANN FORTENBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
5757 ALPHA RD, SUITE 209, DALLAS, TX 75240-4601
(972) 458-9890
(972) 458-9890
Mailing address
5757 ALPHA RD, SUITE 209, DALLAS, TX 75240-4601
(972) 458-9890
(972) 458-9890
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
22645
TX
103TC0700X
Clinical Psychologist
22645
TX
103TC2200X
Clinical Child & Adolescent Psychologist
22645
TX
103TF0000X
Family Psychologist
22645
TX
103TP2701X
Group Psychotherapy Psychologist
22645
TX
106H00000X
Marriage & Family Therapist
Primary
570
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00D39R
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/27/2006
Last updated
09/11/2025
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