Provider Demographics
NPI:1811610702
Name:WATSON, MELANIE LEMAISTRE (PHD)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:LEMAISTRE
Last Name:WATSON
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 1:520 E GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-6246
Mailing Address - Country:US
Mailing Address - Phone:850-591-3301
Mailing Address - Fax:
Practice Address - Street 1:520 E GEORGIA ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-6246
Practice Address - Country:US
Practice Address - Phone:850-591-3301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8772103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist