MEDICARE: DR. MELISSA MEULMAN PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	0810007302	VA

General Provider Information

NPI Number	:	1215777354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELISSA MEULMAN PSYD

Provider Business Mailing Address
First Line	:	1001 N VERMONT ST APT 904
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-4768
Country	:	US
Telephone Number	:	703-953-7958
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 N VERMONT ST APT 904
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-4768
Country	:	US
Telephone Number	:	703-953-7958
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2024
Last Update Date	:	05/28/2024

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