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General NPI Number Information
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NPI Number | 1013133255
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Entity Type | Individual
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Provider Name | MELISSA M GREENE MA., CCC SLP
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Gender | Female
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 19 PERRY ST STE B01
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City | NEWNAN
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State | GA
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Zip | 30263-1918
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Country | US
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Telephone | 678-340-9305
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Fax |
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Provider Business Mailing Address
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Address Line | 1 RED BUD TRL
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City | NEWNAN
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State | GA
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Zip | 30263-3130
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Country | US
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Telephone | 678-340-9305
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP003943
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License Number State | GA
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