Provider Demographics
NPI:1245515873
Name:SPAULDING, MELISSA (MSCCC-SLP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SPAULDING
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:SUE
Other - Last Name:BLANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSCCC-SLP
Mailing Address - Street 1:680 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2407
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-3221
Practice Address - Country:US
Practice Address - Phone:252-535-3028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist