Individual
DR. MELINDA GAYE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPA
Contact information
Practice address
1104 HEREFORD ST, GLEN ROSE, TX 76043
(682) 302-4597
Mailing address
1030 E HWY 377 STE 110169, GRANBURY, TX 76048-1456
(817) 559-7989
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
72023
TX
103T00000X
Psychologist
Primary
14339
TX
103TS0200X
School Psychologist
30157
TX
Other
Enumeration date
12/07/2009
Last updated
05/07/2019
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