Provider Demographics
NPI:1043411978
Name:BOLLING, MELISA ANN (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MELISA
Middle Name:ANN
Last Name:BOLLING
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4390 TODDSBURY DR
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:VA
Mailing Address - Zip Code:24179-1101
Mailing Address - Country:US
Mailing Address - Phone:540-845-2757
Mailing Address - Fax:
Practice Address - Street 1:4390 TODDSBURY DR
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:VA
Practice Address - Zip Code:24179-1101
Practice Address - Country:US
Practice Address - Phone:540-845-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003809235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist