Provider Demographics
NPI:1669171187
Name:WACHLER, MELISSA ALLISON (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ALLISON
Last Name:WACHLER
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 1:4721 TROUSDALE DR STE 206
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37220-1372
Mailing Address - Country:US
Mailing Address - Phone:615-212-9090
Mailing Address - Fax:
Practice Address - Street 1:14807 PLEASANT RIDGE CT
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-5569
Practice Address - Country:US
Practice Address - Phone:248-762-1088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019034934235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist