Provider Demographics
NPI:1194195974
Name:HARRINGTON, MELISSA A (MED, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:MED, ATC, LAT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:LANGSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, ATC, LAT
Mailing Address - Street 1:1254 PINE PORTAGE LOOP
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-7962
Mailing Address - Country:US
Mailing Address - Phone:512-633-9316
Mailing Address - Fax:
Practice Address - Street 1:2801 GATTIS SCHOOL RD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-3808
Practice Address - Country:US
Practice Address - Phone:512-633-9316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-06
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22812255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer