Doctor Name: | MELISSA GRENN-FULLER |
NPI Number: | 1083737761 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SL007517 |
Business Practice Address: | 21010 Shore Dr Meadville, PA - 163355172 |
Business Phone Number: | 8147209965 |
Business Fax Number: | |
Mailing Address: | 21010 Shore Dr, P.o. Box 1506 MEADVILLE |
State: | PA |
Postal Code: | 163355172 |
Phone Number: | 8147209965 |
Fax Number: | |
NPI Enumeration Date: | 04/09/2007 |
NPI Last Update Date: | 06/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SL007517 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |