Individual
DR. DAVID MELLINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
048-0000472
VT
103TA0700X
Adult Development & Aging Psychologist
048-0000472
VT
103TB0200X
Cognitive & Behavioral Psychologist
048-0000472
VT
103TC0700X
Clinical Psychologist
Primary
048-0000472
VT
103TC1900X
Counseling Psychologist
048-0000472
VT
103TC2200X
Clinical Child & Adolescent Psychologist
048-0000472
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009742
—
VT
01
—
41025
MVP HEALTH CARE
VT
01
—
5790
VT BLUE CROSS/BLUE SHIELD
VT
Enumeration date
02/22/2006
Last updated
02/26/2013
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