Provider Demographics
NPI:1871192880
Name:ZASLOW, MELISSA KONIVER (PSYD, NCSP)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:KONIVER
Last Name:ZASLOW
Suffix:
Gender:F
Credentials:PSYD, NCSP
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:KONIVER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:8611 TOWER BRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-5622
Mailing Address - Country:US
Mailing Address - Phone:786-712-7900
Mailing Address - Fax:
Practice Address - Street 1:4600 LINTON BLVD STE 250
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6600
Practice Address - Country:US
Practice Address - Phone:561-223-6568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10570103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent