Provider Demographics
NPI:1821232349
Name:COLBY, MELISSA
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:COLBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 STANFORD RANCH RD
Mailing Address - Street 2:SUITE 134
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5554
Mailing Address - Country:US
Mailing Address - Phone:916-295-8662
Mailing Address - Fax:
Practice Address - Street 1:3031 STANFORD RANCH RD
Practice Address - Street 2:SUITE 134
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5554
Practice Address - Country:US
Practice Address - Phone:916-295-8662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP10113235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist