Healthcare Provider Details

I. General information

NPI: 1750585550
Provider Name (Legal Business Name): MELISSA NOEL CIPYAK CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELISSA NOEL DI ELMO CCC SLP

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W LEE RD
DELRAY BEACH FL
33445-3286
US

IV. Provider business mailing address

115 W LEE RD
DELRAY BEACH FL
33445-3286
US

V. Phone/Fax

Practice location:
  • Phone: 561-638-2038
  • Fax:
Mailing address:
  • Phone: 561-638-2038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA 6808
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: