Provider Demographics
NPI:1912274200
Name:MELI, MARY ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ANN
Last Name:MELI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6635 W COMMERCIAL BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-2141
Mailing Address - Country:US
Mailing Address - Phone:954-726-3926
Mailing Address - Fax:954-726-3948
Practice Address - Street 1:6635 W COMMERCIAL BLVD STE 106
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-2141
Practice Address - Country:US
Practice Address - Phone:954-726-3926
Practice Address - Fax:954-726-3948
Is Sole Proprietor?:No
Enumeration Date:2011-11-30
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical