Provider Demographics
NPI:1659675098
Name:GOVAN-ORMAN, MELISSA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:GOVAN-ORMAN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 SYLVAN ACRES LN
Mailing Address - Street 2:
Mailing Address - City:SCOTT TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18447-7509
Mailing Address - Country:US
Mailing Address - Phone:570-585-7886
Mailing Address - Fax:
Practice Address - Street 1:18 SYLVAN ACRES LN
Practice Address - Street 2:
Practice Address - City:SCOTT TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18447-7509
Practice Address - Country:US
Practice Address - Phone:570-585-7886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009636235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist