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General NPI Number Information
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NPI Number | 1083813976
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Entity Type | Individual
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Provider Name | MELISSA WHITSON
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Gender | Female
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 239 GOLDEN HILL LN
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City | KINGSTON
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State | NY
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Zip | 12401-6441
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Country | US
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Telephone | 834-340-4130
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Fax |
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Provider Business Mailing Address
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Address Line | 557 BROADWAY APT. 29C
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City | PORT EWEN
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State | NY
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Zip | 12466-5603
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Country | US
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Telephone | 845-853-8339
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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