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General NPI Number Information
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NPI Number | 1235474768
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Entity Type | Organization
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Legal Business Name | LISA MELE& ASSOCIATES
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Dates
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Enumeration Date | 12/10/2012
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 6 JOHN JAY RD
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City | FREDERICKSBURG
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State | VA
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Zip | 22405-2965
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Country | US
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Telephone | 540-903-2677
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Fax |
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Provider Business Mailing Address
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Address Line | 6 JOHN JAY RD
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City | FREDERICKSBURG
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State | VA
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Zip | 22405-2965
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Country | US
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Telephone | 540-903-2677
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOIGST
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Name | LISA DIANE MELE
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Credential | M.S., CCC-SLP
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Telephone | 540-903-2677
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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 | 2202001092
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License Number State | VA
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