Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 103G00000X | Clinical Psychologist | PY9480 | FL |
Y | 103TC0700X | Clinical Psychologist | PY9480 | FL |
NPI | 1003171257 |
---|---|
Provider Name | Melina Scally |
First Address | Tarpon Springs, FL 34689-5795 |
Second Address | Tampa, FL 33605-3909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2012 |
Last Update Date | 19/02/2019 |