Provider Demographics
NPI:1568190007
Name:LANDERFELT-OZBOLT, MELANI RAE (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:MELANI
Middle Name:RAE
Last Name:LANDERFELT-OZBOLT
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 DAVIS CIR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5014
Mailing Address - Country:US
Mailing Address - Phone:256-384-8922
Mailing Address - Fax:
Practice Address - Street 1:604 DAVIS CIR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5014
Practice Address - Country:US
Practice Address - Phone:256-384-8922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2262103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling