Provider Demographics
NPI:1659875268
Name:HORIGAN, MELISSA HARRIS (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:HARRIS
Last Name:HORIGAN
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 1:1551 EDEN WAY S
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-9421
Mailing Address - Country:US
Mailing Address - Phone:757-436-3428
Mailing Address - Fax:
Practice Address - Street 1:1551 EDEN WAY S
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-9421
Practice Address - Country:US
Practice Address - Phone:757-436-3428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202002624235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist