Provider Demographics
NPI:1821528142
Name:HILLE, MELISSA ANN (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:HILLE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4239 W 211TH ST
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-1506
Mailing Address - Country:US
Mailing Address - Phone:440-331-4231
Mailing Address - Fax:
Practice Address - Street 1:155 MOORE RD
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-1157
Practice Address - Country:US
Practice Address - Phone:440-933-8131
Practice Address - Fax:440-933-7025
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP7242235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist