Provider Demographics
NPI:1770516759
Name:DUNPHY, MELISSA (PSYD)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:DUNPHY
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 1:37 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1910
Mailing Address - Country:US
Mailing Address - Phone:330-535-8181
Mailing Address - Fax:330-535-9303
Practice Address - Street 1:4450 BELDEN VILLAGE ST NW
Practice Address - Street 2:SUITE 701
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2552
Practice Address - Country:US
Practice Address - Phone:330-493-2554
Practice Address - Fax:330-535-9303
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5992103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHDUCP31801Medicare ID - Type Unspecified