Organization
MARY E MELTON, PHD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MELTON PHD (LICENSED PSYCHOLOGIST CEO)
(770) 962-1944
Entity
Organization
Contact information
Practice address
1805 HERRINGTON RD, #2, LAWRENCEVILLE, GA 30043-5649
(770) 962-1944
Mailing address
1805 HERRINGTON RD, #2, LAWRENCEVILLE, GA 30043-5649
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1641
GA
Other
Enumeration date
04/02/2007
Last updated
08/22/2007
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