Provider Demographics
NPI:1356838650
Name:METZGER, MELISSA (PSYD, NCSP)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:METZGER
Suffix:
Gender:F
Credentials:PSYD, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 MOHR AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53405-2645
Mailing Address - Country:US
Mailing Address - Phone:262-664-6162
Mailing Address - Fax:
Practice Address - Street 1:2340 MOHR AVE
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53405
Practice Address - Country:US
Practice Address - Phone:262-664-6162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool