Provider Demographics
NPI:1598193674
Name:DORGAN, MELISSA (MS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:DORGAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1158 INDIAN CHURCH RD
Mailing Address - Street 2:#2
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1334
Mailing Address - Country:US
Mailing Address - Phone:716-677-6427
Mailing Address - Fax:
Practice Address - Street 1:1158 INDIAN CHURCH RD
Practice Address - Street 2:#2
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1334
Practice Address - Country:US
Practice Address - Phone:716-677-6427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-28
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist