Provider Demographics
NPI:1598088296
Name:CRAWFORD, MELANIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:
Last Name:CRAWFORD
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 1:6121 LAKESIDE DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-8502
Mailing Address - Country:US
Mailing Address - Phone:775-786-7881
Mailing Address - Fax:775-800-4990
Practice Address - Street 1:6121 LAKESIDE DR
Practice Address - Street 2:SUITE 230
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-8502
Practice Address - Country:US
Practice Address - Phone:775-786-7881
Practice Address - Fax:775-800-4990
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPSY0495103G00000X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent