Provider Demographics
NPI:1518598481
Name:ALFORD, MELODY ANNE
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:ANNE
Last Name:ALFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 FAIRWOOD CT
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5063
Mailing Address - Country:US
Mailing Address - Phone:903-456-1203
Mailing Address - Fax:
Practice Address - Street 1:9201 FAIRWOOD CT
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-5063
Practice Address - Country:US
Practice Address - Phone:903-456-1203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76167101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor