Doctor Name: | DR. MELENEY BLANCHFORD SCUDDER |
NPI Number: | 1164662839 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | 002417 |
Business Practice Address: | 300 Hebron Ave Suite 217 Glastonbury, CT - 060332176 |
Business Phone Number: | 8606592697 |
Business Fax Number: | 8606593468 |
Mailing Address: | 300 Hebron Ave, Suite 217 GLASTONBURY |
State: | CT |
Postal Code: | 060332176 |
Phone Number: | 8606592697 |
Fax Number: | 8606593468 |
NPI Enumeration Date: | 02/20/2009 |
NPI Last Update Date: | 02/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 002417 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |