Provider Demographics
NPI:1679729032
Name:PHILBRICK, MELANIE MARIE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:MARIE
Last Name:PHILBRICK
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MS
Other - First Name:MELANIE
Other - Middle Name:MARIE
Other - Last Name:BREWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5140 ONONDAGA RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13215-1406
Mailing Address - Country:US
Mailing Address - Phone:315-395-2747
Mailing Address - Fax:
Practice Address - Street 1:5140 ONONDAGA RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215-1406
Practice Address - Country:US
Practice Address - Phone:315-395-2747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018214-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist