Healthcare Provider Details

I. General information

NPI: 1790176212
Provider Name (Legal Business Name): MELISSA SKOCYPEC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2015
Last Update Date: 02/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 HOSIER ST
SELBYVILLE DE
19975-9300
US

IV. Provider business mailing address

31 HOSIER ST
SELBYVILLE DE
19975-9300
US

V. Phone/Fax

Practice location:
  • Phone: 302-436-1000
  • Fax: 302-684-8931
Mailing address:
  • Phone: 302-436-1000
  • Fax: 302-684-8931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberO10001437
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: