Provider Demographics
NPI:1235280173
Name:BLASS, MELANIE ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:ANN
Last Name:BLASS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1222 COMMERCE ST APT 1615
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75202-4359
Mailing Address - Country:US
Mailing Address - Phone:214-793-5667
Mailing Address - Fax:214-749-0846
Practice Address - Street 1:1700 COIT RD STE 110
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6138
Practice Address - Country:US
Practice Address - Phone:972-612-4007
Practice Address - Fax:972-612-3188
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8348101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional