Petersen, Melissa Edwards

Petersen, Melissa Edwards is an individual health care provider with primary practice located at 855 Montgomery St , Fort Worth TX 76107-2553. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is her primary health care specialty. Petersen, Melissa Edwards can be contacted via phone (817) 735-2200.

Contact Information

Primary practice address
855 Montgomery St Fort Worth TX 76107-2553
Phone: (817) 735-2200
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 36939 Texas
Behavioral Health & Social Service Providers / Clinical 103TC0700X 36939 Texas

Profile Details

NPI number 1144860917
LBN Legal business name Petersen, Melissa Edwards
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2020
Last updated Oct 15th, 2020 - about 4 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.

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