| Doctor Name: | DR. MELISSA FOGLE |
| NPI Number: | 1063697779 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | PY7553 |
| Business Practice Address: | 2737 W Fairbanks Ave Winter Park, FL - 327893314 |
| Business Phone Number: | 4077406838 |
| Business Fax Number: | 4077400902 |
| Mailing Address: | 2737 W Fairbanks Ave, WINTER PARK |
| State: | FL |
| Postal Code: | 327893314 |
| Phone Number: | 4077406838 |
| Fax Number: | 4077400902 |
| NPI Enumeration Date: | 01/02/2008 |
| NPI Last Update Date: | 01/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103G00000X |
| License Number: | PY7553 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Clinical Neuropsychologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |