Provider Demographics
NPI:1346338522
Name:HARRELL, MELISSA GREEN (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:GREEN
Last Name:HARRELL
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:JAYNE
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4780 OLD SALEM RD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129
Mailing Address - Country:US
Mailing Address - Phone:615-867-4975
Mailing Address - Fax:
Practice Address - Street 1:300 STONE CREST BLVD
Practice Address - Street 2:SUITE 375
Practice Address - City:SMYRNA
Practice Address - State:TX
Practice Address - Zip Code:37167
Practice Address - Country:US
Practice Address - Phone:615-220-5796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2916235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist