Provider Demographics
NPI:1578748372
Name:DUNBAR, MELANIE JEANETTE (PHD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:JEANETTE
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 W LAKE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505
Mailing Address - Country:US
Mailing Address - Phone:814-790-4567
Mailing Address - Fax:814-295-4074
Practice Address - Street 1:3250 W LAKE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505
Practice Address - Country:US
Practice Address - Phone:814-790-4567
Practice Address - Fax:814-295-4074
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004728101YM0800X
PAPS017676103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health