Provider Demographics
NPI:1558800417
Name:NALLS, MELODY (MS, QMHP)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:
Last Name:NALLS
Suffix:
Gender:F
Credentials:MS, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 MIDDLE RUN
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-2028
Mailing Address - Country:US
Mailing Address - Phone:214-264-8074
Mailing Address - Fax:
Practice Address - Street 1:802 MIDDLE RUN
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-2028
Practice Address - Country:US
Practice Address - Phone:214-264-8074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor