Melbourne Integrative Psychology | |
3270 Suntree Blvd Suite 1135 Melbourne FL 32940-7530 | |
(412) 303-0157 | |
Not Available |
Full Name | Melbourne Integrative Psychology |
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Speciality | Psychologist |
Location | 3270 Suntree Blvd, Melbourne, Florida |
Authorized Official Name and Position | Laurie M Donaldson (PRESIDENT) |
Authorized Official Contact | 4123030157 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Melbourne Integrative Psychology 5954 Newbury Cir Melbourne FL 32940-1880 Ph: (412) 303-0157 | Melbourne Integrative Psychology 3270 Suntree Blvd Suite 1135 Melbourne FL 32940-7530 Ph: (412) 303-0157 |
NPI Number | 1154873750 |
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Provider Enumeration Date | 10/30/2016 |
Last Update Date | 10/30/2016 |
Medicare PECOS PAC ID | 3870876295 |
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Medicare Enrollment ID | O20170209001491 |
Identifier | Type | State | Issuer |
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1154873750 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103T00000X | Psychologist | PY9009 (Florida) | Primary |
Provider Name | Laurie Marie Donaldson |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1356369961 PECOS PAC ID: 9931099678 Enrollment ID: I20141030000751 |
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