Provider Demographics
NPI:1497215826
Name:MELMS, HEATHER ALLISON (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ALLISON
Last Name:MELMS
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 1:130 DANIEL AVE
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2717
Mailing Address - Country:US
Mailing Address - Phone:732-832-1171
Mailing Address - Fax:
Practice Address - Street 1:16 PARK AVE STE 304
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-1750
Practice Address - Country:US
Practice Address - Phone:201-298-3727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01048300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist