Provider Demographics
NPI:1790975548
Name:WEBB, MELISSA S (MA)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:S
Last Name:WEBB
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:396 BLENHEIM RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3220
Mailing Address - Country:US
Mailing Address - Phone:330-495-9237
Mailing Address - Fax:
Practice Address - Street 1:7840 GRAPHICS WAY
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035
Practice Address - Country:US
Practice Address - Phone:740-657-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-8814235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0094740Medicaid