Provider Demographics
NPI:1437369261
Name:SPIESS, MELISSA AMY (MM, MT-BC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:AMY
Last Name:SPIESS
Suffix:
Gender:F
Credentials:MM, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-5257
Mailing Address - Country:US
Mailing Address - Phone:952-240-6130
Mailing Address - Fax:
Practice Address - Street 1:2518 LONGVIEW DR
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-5257
Practice Address - Country:US
Practice Address - Phone:952-240-6130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist