Provider Demographics
NPI:1710213988
Name:SHEPSKI, MELISSA (BCABA)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SHEPSKI
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 CHERRY GROVE RD N
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23432-1811
Mailing Address - Country:US
Mailing Address - Phone:757-934-6470
Mailing Address - Fax:757-255-4281
Practice Address - Street 1:156 BURNETTS WAY
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8166
Practice Address - Country:US
Practice Address - Phone:757-934-6470
Practice Address - Fax:757-255-4281
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist