Healthcare Provider Details

I. General information

NPI: 1235114034
Provider Name (Legal Business Name): MELISSA DEE HILLER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELISSA DEE HILLER LAUBY PH.D.

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 DEWITT LOOP
FORT BELVOIR VA
22060
US

IV. Provider business mailing address

9300 DEWITT LOOP
FORT BELVOIR VA
22060
US

V. Phone/Fax

Practice location:
  • Phone: 703-805-0113
  • Fax:
Mailing address:
  • Phone: 703-805-0113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number833
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: