Provider Demographics
NPI:1912786229
Name:ST-ONGE, MELANIE ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:ANNE
Last Name:ST-ONGE
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 1:1831 N BELCHER RD STE E2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-1442
Mailing Address - Country:US
Mailing Address - Phone:727-228-2388
Mailing Address - Fax:
Practice Address - Street 1:1831 N BELCHER RD STE E2
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1442
Practice Address - Country:US
Practice Address - Phone:727-228-2388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY11874103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty