Provider Demographics
NPI:1639579097
Name:BENDIXSEN, MELISSA
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BENDIXSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 DALWHAMIE STREET
Mailing Address - Street 2:
Mailing Address - City:KINROSS
Mailing Address - State:UNITED KINGDOM/SCOTLAND
Mailing Address - Zip Code:KY13 8RG
Mailing Address - Country:GB
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:63 DALWHAMIE STREET
Practice Address - Street 2:
Practice Address - City:KINROSS
Practice Address - State:UNITED KINGDOM/SCOTLAND
Practice Address - Zip Code:KY13 8RG
Practice Address - Country:GB
Practice Address - Phone:078-575-6757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDTSLP-2634235Z00000X
IDSLP-2808235Z00000X
CA34407235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist