Provider Demographics
NPI:1235285792
Name:HOOPER, MELISSA A (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:A
Last Name:HOOPER
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:ZETS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC SLP
Mailing Address - Street 1:280 CENTRAL AVE
Mailing Address - Street 2:W123 THOMPSON HALL
Mailing Address - City:FREDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14063-1127
Mailing Address - Country:US
Mailing Address - Phone:716-673-3203
Mailing Address - Fax:716-673-3235
Practice Address - Street 1:280 CENTRAL AVE
Practice Address - Street 2:W123 THOMPSON HALL
Practice Address - City:FREDONIA
Practice Address - State:NY
Practice Address - Zip Code:14063-1127
Practice Address - Country:US
Practice Address - Phone:716-673-3203
Practice Address - Fax:716-673-3235
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009919-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist