Provider Demographics
NPI:1801828504
Name:VAIL, MELANIE A (MS, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:A
Last Name:VAIL
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:BOURNE
Mailing Address - State:MA
Mailing Address - Zip Code:02532-3756
Mailing Address - Country:US
Mailing Address - Phone:508-759-0916
Mailing Address - Fax:508-759-0995
Practice Address - Street 1:1 COUNTY RD
Practice Address - Street 2:
Practice Address - City:BOURNE
Practice Address - State:MA
Practice Address - Zip Code:02532-3756
Practice Address - Country:US
Practice Address - Phone:508-759-0916
Practice Address - Fax:508-759-0995
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002006-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist