Individual
DR. MELISSA L. GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD, LP
Contact information
Practice address
101 E PIER ST STE 2, PORT WASHINGTON, WI 53074-1939
(262) 284-5789
Mailing address
101 E PIER ST STE 2, PORT WASHINGTON, WI 53074-1939
(262) 284-5789
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3373-57
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
903417100
—
WI
Enumeration date
08/28/2007
Last updated
04/26/2018
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