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General NPI Number Information
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NPI Number | 1477740652
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Entity Type | Individual
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Provider Name | MELISSA BAILEY MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 10/24/2011
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Provider Practice Location Address
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Address Line | 3300 ONE PL
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City | JONESBORO
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State | AR
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Zip | 72404-9318
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Country | US
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Telephone | 870-910-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 3309 SAINT ANDREWS CV
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City | JONESBORO
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State | AR
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Zip | 72401-8023
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Country | US
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Telephone | 870-932-3724
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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 | SP#916
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License Number State | AR
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