Doctor Name: | MS. MELODY ANN PRATT |
NPI Number: | 1205158284 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 63451 |
Business Practice Address: | 6640 Moss Ln Watauga, TX - 761481531 |
Business Phone Number: | 8176053703 |
Business Fax Number: | |
Mailing Address: | 6640 Moss Ln, WATAUGA |
State: | TX |
Postal Code: | 761481531 |
Phone Number: | 8176053703 |
Fax Number: | |
NPI Enumeration Date: | 02/18/2010 |
NPI Last Update Date: | 02/18/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 63451 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |