Provider Demographics
NPI:1932675444
Name:BEARD, MELISSA H (MS, CCC, SLP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:H
Last Name:BEARD
Suffix:
Gender:F
Credentials:MS, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:993 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-4432
Mailing Address - Country:US
Mailing Address - Phone:931-363-3572
Mailing Address - Fax:931-363-5001
Practice Address - Street 1:319 COTTON LN
Practice Address - Street 2:
Practice Address - City:LEOMA
Practice Address - State:TN
Practice Address - Zip Code:38468-5259
Practice Address - Country:US
Practice Address - Phone:931-201-1513
Practice Address - Fax:931-363-5001
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP0000003413235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist