Healthcare Provider Details

I. General information

NPI: 1356353007
Provider Name (Legal Business Name): SOLUTIONS IN PSYCHOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 09/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13670 METROPOLIS AVE SUITE 100
FORT MYERS FL
33912-4346
US

IV. Provider business mailing address

13670 METROPOLIS AVE SUITE 101
FORT MYERS FL
33912-4346
US

V. Phone/Fax

Practice location:
  • Phone: 239-910-1534
  • Fax:
Mailing address:
  • Phone: 239-910-1534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY9023
License Number StateFL

VIII. Authorized Official

Name: JEFF N MELVIN
Title or Position: OWNER
Credential: PH.D.
Phone: 239-910-1534