Individual
YEVGENIYA KUTUZOVA MELNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
60 MARKET ST STE 213, GAITHERSBURG, MD 20878-6559
(240) 750-6467
Mailing address
60 MARKET ST STE 213, GAITHERSBURG, MD 20878-6559
(240) 750-6467
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
—
—
103TC0700X
Clinical Psychologist
Primary
06053
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06053
PSYCHOLOGY LICENSE
MD
Enumeration date
09/01/2011
Last updated
03/15/2019
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