Provider Demographics
NPI:1992139299
Name:WINTERS, MELISSA JM (PSYD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:JM
Last Name:WINTERS
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 1:3504 PLANK RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-6896
Mailing Address - Country:US
Mailing Address - Phone:540-999-6221
Mailing Address - Fax:
Practice Address - Street 1:3504 PLANK RD
Practice Address - Street 2:SUITE 302
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-6896
Practice Address - Country:US
Practice Address - Phone:540-999-6221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004844103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical