Healthcare Provider Details

I. General information

NPI: 1306819669
Provider Name (Legal Business Name): MELISSA ANNE PALIANI PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 04/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 W PLYMOUTH AVE
DELAND FL
32720-2745
US

IV. Provider business mailing address

125 W PLYMOUTH AVE
DELAND FL
32720-2745
US

V. Phone/Fax

Practice location:
  • Phone: 386-736-9165
  • Fax:
Mailing address:
  • Phone: 386-736-9165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2370
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY9252
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: