Provider Demographics
NPI:1770835274
Name:SHAPIRO, MELISSA S (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:S
Last Name:SHAPIRO
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 1:2001 HAMILTON ST
Mailing Address - Street 2:APT 721
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-4201
Mailing Address - Country:US
Mailing Address - Phone:215-370-2713
Mailing Address - Fax:
Practice Address - Street 1:2001 HAMILTON STREET
Practice Address - Street 2:APT 721
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130
Practice Address - Country:US
Practice Address - Phone:215-370-2713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00701400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist