Provider Demographics
NPI:1801080593
Name:MORRISON, MELISSE KNOLL (MSCCC-SLP)
Entity type:Individual
Prefix:
First Name:MELISSE
Middle Name:KNOLL
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2653 BEDFORD WAY
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-4619
Mailing Address - Country:US
Mailing Address - Phone:775-882-8717
Mailing Address - Fax:
Practice Address - Street 1:2653 BEDFORD WAY
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4619
Practice Address - Country:US
Practice Address - Phone:775-882-8717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV573235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist