Provider Demographics
NPI:1598120511
Name:WATT, MELANIE R (PSYD, BCB)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:R
Last Name:WATT
Suffix:
Gender:F
Credentials:PSYD, BCB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9546 S DALLMAN DR
Mailing Address - Street 2:UNIT 986
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-2037
Mailing Address - Country:US
Mailing Address - Phone:484-424-7655
Mailing Address - Fax:
Practice Address - Street 1:10791 KITTY DR
Practice Address - Street 2:
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-7747
Practice Address - Country:US
Practice Address - Phone:720-689-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-17
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018172103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist