Provider Demographics
NPI:1639319593
Name:SWARTZ, MELISSA J (MSED CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:J
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:MSED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13226 WARNER HILL RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH WALES
Mailing Address - State:NY
Mailing Address - Zip Code:14139-9745
Mailing Address - Country:US
Mailing Address - Phone:716-457-3209
Mailing Address - Fax:
Practice Address - Street 1:13226 WARNER HILL RD
Practice Address - Street 2:
Practice Address - City:SOUTH WALES
Practice Address - State:NY
Practice Address - Zip Code:14139-9745
Practice Address - Country:US
Practice Address - Phone:716-457-3209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018766-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist