Provider Demographics
NPI:1407117880
Name:BAKER, MELISSA ANNE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANNE
Last Name:BAKER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7160 CHAGRIN RD STE 175
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-1139
Mailing Address - Country:US
Mailing Address - Phone:440-972-3670
Mailing Address - Fax:
Practice Address - Street 1:7160 CHAGRIN RD STE 175
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-1139
Practice Address - Country:US
Practice Address - Phone:440-972-3670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-02
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7654235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist