Healthcare Provider Details

I. General information

NPI: 1952416893
Provider Name (Legal Business Name): DONNA ANN MELDER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 17TH ST S
BIRMINGHAM AL
35205-4718
US

IV. Provider business mailing address

150 GLENWOOD LN
BIRMINGHAM AL
35242-5700
US

V. Phone/Fax

Practice location:
  • Phone: 205-212-6720
  • Fax: 205-212-6688
Mailing address:
  • Phone: 205-969-2880
  • Fax: 205-212-6688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2183
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: