Provider Demographics
NPI:1447425400
Name:REDDITT, MELISSA RENEE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:RENEE
Last Name:REDDITT
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 1:983 LEE RD
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-8437
Mailing Address - Country:US
Mailing Address - Phone:828-565-0121
Mailing Address - Fax:
Practice Address - Street 1:1349 CRABTREE RD
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28785-7315
Practice Address - Country:US
Practice Address - Phone:828-456-8966
Practice Address - Fax:828-456-5049
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7355235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist