Provider Demographics
NPI:1588087209
Name:PEARSON, MELINDA MARIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:MARIE
Last Name:PEARSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 203
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:NE
Mailing Address - Zip Code:68443
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:315 MAIN STREET
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:NE
Practice Address - Zip Code:65443
Practice Address - Country:US
Practice Address - Phone:402-309-3062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE#781103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist