Provider Demographics
NPI:1073879540
Name:PACEY MAHAFFEY, MELISSA (AUD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:PACEY MAHAFFEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1298 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WEST NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-2001
Mailing Address - Country:US
Mailing Address - Phone:617-332-7244
Mailing Address - Fax:
Practice Address - Street 1:1298 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WEST NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02465-2001
Practice Address - Country:US
Practice Address - Phone:617-332-7244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA157474237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter