Individual
MELINDA LONGTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1600 W 38TH ST STE 428, AUSTIN, TX 78731-6409
(512) 454-3685
(512) 454-3689
Mailing address
1600 W 38TH ST STE 428, AUSTIN, TX 78731-6409
(512) 454-3685
(512) 454-3689
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
24544
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00P45P
BCBS
TX
Enumeration date
12/28/2006
Last updated
07/08/2007
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