Fortenberry, Melody Ann
Fortenberry, Melody Ann is an sole proprietor health care provider with primary practice located at 5757 Alpha Rd Suite 209, Dallas TX 75240-4601. She recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / Group Psychotherapy, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Fortenberry, Melody Ann can be contacted via phone (972) 458-9890.Contact Information
Primary practice address
5757 Alpha Rd Suite 209
Dallas TX 75240-4601
Phone: (972) 458-9890
Fax: (972) 458-9890
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 22645 | Texas |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 22645 | Texas |
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 22645 | Texas |
| Behavioral Health & Social Service Providers / Family | 103TF0000X | 22645 | Texas |
| Behavioral Health & Social Service Providers / Group Psychotherapy | 103TP2701X | 22645 | Texas |
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 570 | Texas |
Profile Details
| NPI number | 1356417877 |
|---|---|
| LBN Legal business name | Fortenberry, Melody Ann |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 27th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356417877 | NPPES |
| Texas | Other | 00D39R | BLUE CROSS BLUE SHIELD |
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