Healthcare Provider Details

I. General information

NPI: 1013353697
Provider Name (Legal Business Name): MELISSA HOULIHAN AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2013
Last Update Date: 05/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 MASSACHUSETTS AVE
NORTH ANDOVER MA
01845-4143
US

IV. Provider business mailing address

198 MASSACHUSETTS AVE
NORTH ANDOVER MA
01845-4143
US

V. Phone/Fax

Practice location:
  • Phone: 978-685-7550
  • Fax:
Mailing address:
  • Phone: 978-685-7550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberSP-1006-AU
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: