Doctor Name: | MELISSA FREDERICK |
NPI Number: | 1205051471 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.SP.CCC.SLP |
License Number: | SLP006030 |
Business Practice Address: | 245 Lawn Market Sharpsburg, GA - 302771511 |
Business Phone Number: | 6784923391 |
Business Fax Number: | 7704518304 |
Mailing Address: | Po Box 478, TYRONE |
State: | GA |
Postal Code: | 302900478 |
Phone Number: | 6784923391 |
Fax Number: | 7704518304 |
NPI Enumeration Date: | 04/14/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP006030 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
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 |