Provider Demographics
NPI:1891818704
Name:HANDY, MELISSA R (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:R
Last Name:HANDY
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 1:320 CUSTER ROAD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080
Mailing Address - Country:US
Mailing Address - Phone:972-490-9055
Mailing Address - Fax:972-490-9058
Practice Address - Street 1:320 CUSTER ROAD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:972-490-9055
Practice Address - Fax:972-490-9058
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05163235Z00000X
TX110450235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist