Provider Demographics
NPI:1225294465
Name:POGHOSSIAN, MELISSA A (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:A
Last Name:POGHOSSIAN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17869 N 93RD ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6029
Mailing Address - Country:US
Mailing Address - Phone:480-540-4289
Mailing Address - Fax:480-840-1424
Practice Address - Street 1:17869 N 93RD ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6029
Practice Address - Country:US
Practice Address - Phone:480-540-4289
Practice Address - Fax:480-840-1424
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ828634OtherAHCCCS