Healthcare Provider Details

I. General information

NPI: 1609540855
Provider Name (Legal Business Name): MELODY FLOR CONTRERAS RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1708 PEACHTREE ST NW STE 425
ATLANTA GA
30309-7020
US

IV. Provider business mailing address

1708 PEACHTREE ST NW STE 425
ATLANTA GA
30309-7020
US

V. Phone/Fax

Practice location:
  • Phone: 404-565-4385
  • Fax:
Mailing address:
  • Phone: 404-565-4385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: