Provider Demographics
NPI:1336178946
Name:ANDERSON-POLLINO, MELISSA L (AUD)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:L
Last Name:ANDERSON-POLLINO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:L
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:555 W 14 MILE RD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-3100
Mailing Address - Country:US
Mailing Address - Phone:248-435-6811
Mailing Address - Fax:248-435-6855
Practice Address - Street 1:555 W 14 MILE RD
Practice Address - Street 2:SUITE 2A
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-3100
Practice Address - Country:US
Practice Address - Phone:248-435-6811
Practice Address - Fax:248-435-6855
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000050231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist