Provider Demographics
NPI:1972703833
Name:BUCHHOLZ, MELISSA A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:A
Last Name:BUCHHOLZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13123 E 16TH AVE
Mailing Address - Street 2:B130
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7106
Mailing Address - Country:US
Mailing Address - Phone:720-777-4920
Mailing Address - Fax:720-777-7309
Practice Address - Street 1:13123 E 16TH AVE
Practice Address - Street 2:B130
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-777-4920
Practice Address - Fax:720-777-7309
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3371103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical