Provider Demographics
NPI:1598754681
Name:WEITZENFELD, MELANIE S (PHD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:S
Last Name:WEITZENFELD
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 1:7400 E ORCHARD RD
Mailing Address - Street 2:SUITE 240 SOUTH
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2528
Mailing Address - Country:US
Mailing Address - Phone:303-596-0454
Mailing Address - Fax:888-299-1224
Practice Address - Street 1:7400 E ORCHARD RD
Practice Address - Street 2:SUITE 240 SOUTH
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2528
Practice Address - Country:US
Practice Address - Phone:303-596-0454
Practice Address - Fax:888-299-1224
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3106103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist