Provider Demographics
NPI:1750875746
Name:POOK, MELISSA ANN
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ANN
Last Name:POOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 14TH ST APT 804
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-6718
Mailing Address - Country:US
Mailing Address - Phone:201-925-3635
Mailing Address - Fax:
Practice Address - Street 1:1 14TH ST APT 804
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-6718
Practice Address - Country:US
Practice Address - Phone:201-925-3635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-21
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00864900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist