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General NPI Number Information
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NPI Number | 1932776739
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Entity Type | Individual
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Provider Name | MELISSA MARIN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 06/09/2021
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 13420 REESE BLVD W
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-7925
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Country | US
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Telephone | 980-283-2403
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Fax |
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Provider Business Mailing Address
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Address Line | 124 FERN LN
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City | TROUTMAN
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State | NC
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Zip | 28166-0160
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Country | US
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Telephone | 813-507-8522
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6502
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License Number State | NC
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