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NPI Code Detail

MEDICARE: MELISSA MARIE MCKELVIE PH.D.

MEDICARE:   MELISSA MARIE MCKELVIE  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist5810OH

General Provider Information

NPI Number : 1760696157
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA MARIE MCKELVIE PH.D.
Provider Business Mailing Address
First Line : 4448 VICTOR AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45242-6722
Country : US
Telephone Number : 513-791-0059
Fax Number :
Provider Business Practice Location Address
First Line : 7826 COOPER RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45242-7619
Country : US
Telephone Number : 513-984-1000
Fax Number : 513-985-2182
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 07/08/2007

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