Provider Demographics
NPI:1043520539
Name:FRANKLIN, MELISSA MARIE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18546 MERSEYSIDE LOOP
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-7956
Mailing Address - Country:US
Mailing Address - Phone:813-310-1479
Mailing Address - Fax:
Practice Address - Street 1:18546 MERSEYSIDE LOOP
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-7956
Practice Address - Country:US
Practice Address - Phone:813-310-1479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP10410235Z00000X
FLSZ5242235Z00000X
FLSA16606235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist