Provider Demographics
NPI:1043448020
Name:HELLER, MELISSA W
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:W
Last Name:HELLER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:WENDY
Other - Last Name:PRINCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS,CCC,SLP
Mailing Address - Street 1:325 E 57TH ST
Mailing Address - Street 2:APT 4A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2935
Mailing Address - Country:US
Mailing Address - Phone:917-903-9602
Mailing Address - Fax:
Practice Address - Street 1:325 E 57TH ST
Practice Address - Street 2:APT 4A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2935
Practice Address - Country:US
Practice Address - Phone:917-903-9602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-29
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006481235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist