Provider Demographics
NPI:1891493672
Name:YARBOROUGH, MELISSA (PYSD, HSP-P)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:YARBOROUGH
Suffix:
Gender:F
Credentials:PYSD, HSP-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 JOHN BREWER RD
Mailing Address - Street 2:
Mailing Address - City:ROXBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27574-1101
Mailing Address - Country:US
Mailing Address - Phone:850-319-8818
Mailing Address - Fax:
Practice Address - Street 1:115 KILDAIRE PARK DR STE 313
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8144
Practice Address - Country:US
Practice Address - Phone:919-600-4936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4512103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist