Healthcare Provider Details

I. General information

NPI: 1679809768
Provider Name (Legal Business Name): MELISSA N OLIVETT PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2009
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 WELLS ST STE 203D
SARATOGA SPRINGS NY
12866-1238
US

IV. Provider business mailing address

7 WELLS ST STE 203D
SARATOGA SPRINGS NY
12866-1238
US

V. Phone/Fax

Practice location:
  • Phone: 518-620-8810
  • Fax:
Mailing address:
  • Phone: 518-620-8810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number018344
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number018344
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: