Provider Demographics
NPI:1013277995
Name:MELZNER, BETTY LYNN (LMHC, MED)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:LYNN
Last Name:MELZNER
Suffix:
Gender:F
Credentials:LMHC, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5434 JOHN REYNOLDS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-1342
Mailing Address - Country:US
Mailing Address - Phone:904-626-4982
Mailing Address - Fax:
Practice Address - Street 1:5434 JOHN REYNOLDS DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-1342
Practice Address - Country:US
Practice Address - Phone:904-626-4982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMHC8010101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health