Healthcare Provider Details

I. General information

NPI: 1568587186
Provider Name (Legal Business Name): MELISSA K. HALPERN M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4629 OAK SHORES DR
PLANO TX
75024-6826
US

IV. Provider business mailing address

4629 OAK SHORES DR
PLANO TX
75024-6826
US

V. Phone/Fax

Practice location:
  • Phone: 469-569-9120
  • Fax:
Mailing address:
  • Phone: 469-569-9120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number112468
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: