Melissa Dreffin, PSYD
Individual provider Active NPI Clinical Psychologist · Boise, ID
NPI 1508102898 · NPPES record last updated Mar 20, 2014
Key facts
- NPI
- 1508102898
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY-202779 (ID)
- Practice address
- 500 W Fort St
Boise, ID 83702-4501 - Phone
- (208) 422-1000
- NPI assigned
- Dec 14, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY-202779 | ID | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY-202779 | ID | Yes |
Addresses
Primary practice location
500 W Fort St
Boise, ID 83702-4501
Mailing address
500 W Fort St
Boise, ID 83702-4501
Phone (208) 422-1000
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.