Provider Demographics
NPI:1922628908
Name:CONNOR, MELINDA H (DD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:H
Last Name:CONNOR
Suffix:
Gender:F
Credentials:DD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31907 SOUTH DAVIS RANCH RD
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85658
Mailing Address - Country:US
Mailing Address - Phone:520-609-1765
Mailing Address - Fax:
Practice Address - Street 1:31907 SOUTH DAVIS RANCH RD
Practice Address - Street 2:
Practice Address - City:MARANA
Practice Address - State:AZ
Practice Address - Zip Code:85658
Practice Address - Country:US
Practice Address - Phone:520-609-1765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner