Provider Demographics
NPI:1609297704
Name:ANDREWS-SALVIA, MELISSA (CCC/SLP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ANDREWS-SALVIA
Suffix:
Gender:F
Credentials: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 NOTTINGHAM LN
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-7641
Mailing Address - Country:US
Mailing Address - Phone:505-401-2036
Mailing Address - Fax:888-245-1902
Practice Address - Street 1:983 NOTTINGHAM LN
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-7641
Practice Address - Country:US
Practice Address - Phone:505-401-2036
Practice Address - Fax:888-245-1902
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-17
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109518235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist