Healthcare Provider Details

I. General information

NPI: 1346689718
Provider Name (Legal Business Name): MRS. MELISSA ALLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 PARK TERRACE DR
CLYDE NC
28721-7445
US

IV. Provider business mailing address

74 LOWELL ST
WAYNESVILLE NC
28786-6807
US

V. Phone/Fax

Practice location:
  • Phone: 321-277-2527
  • Fax:
Mailing address:
  • Phone: 321-277-2527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14352
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: