Healthcare Provider Details

I. General information

NPI: 1396050811
Provider Name (Legal Business Name): MELISSA BAY BRIDGES SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2010
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

382 W MAIN ST
FOREST CITY NC
28043-3027
US

IV. Provider business mailing address

382 W MAIN ST
FOREST CITY NC
28043-3027
US

V. Phone/Fax

Practice location:
  • Phone: 828-288-2200
  • Fax:
Mailing address:
  • Phone: 828-288-2200
  • Fax: 828-288-2490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number8972
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: