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General NPI Number Information
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NPI Number | 1528482155
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Entity Type | Individual
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Provider Name | KATHERINE ALISON MELCHIOR PHD
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Gender | Female
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Dates
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Enumeration Date | 02/18/2014
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Last Update Date | 06/01/2018
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Provider Practice Location Address
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Address Line | 17199 N LAUREL PARK DR STE 306
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City | LIVONIA
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State | MI
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Zip | 48152-7904
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Country | US
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Telephone | 734-589-3048
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Fax |
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Provider Business Mailing Address
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Address Line | 17199 N LAUREL PARK DR STE 306
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City | LIVONIA
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State | MI
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Zip | 48152-7904
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Country | US
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Telephone | 734-589-3048
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301014731
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License Number State | MI
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