Provider Demographics
NPI:1700622750
Name:MELIKA, DEENA (PHD)
Entity type:Individual
Prefix:DR
First Name:DEENA
Middle Name:
Last Name:MELIKA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1221
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-5221
Mailing Address - Country:US
Mailing Address - Phone:551-221-4423
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1221
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-5221
Practice Address - Country:US
Practice Address - Phone:551-221-4423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008263103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical