Provider Demographics
NPI:1598083859
Name:ZERIAL, MELISSA KAYE BAEHRE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:KAYE BAEHRE
Last Name:ZERIAL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:1543 EDGEWOOD AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-5044
Mailing Address - Country:US
Mailing Address - Phone:616-826-5009
Mailing Address - Fax:
Practice Address - Street 1:3351 EAGLE RUN DR NE STE C
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-7070
Practice Address - Country:US
Practice Address - Phone:616-365-8920
Practice Address - Fax:616-365-8971
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI01095501235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist