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General NPI Number Information
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NPI Number | 1508998998
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Entity Type | Individual
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Provider Name | MELISSA GIBB MUIR M.A., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10124 W BROAD ST
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City | GLEN ALLEN
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State | VA
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Zip | 23060-3330
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Country | US
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Telephone | 804-527-3406
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Fax |
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Provider Business Mailing Address
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Address Line | 9209 NEWTONWOOD CT
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City | GLEN ALLEN
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State | VA
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Zip | 23060-9268
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Country | US
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Telephone | 804-338-0256
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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 | 2202003168
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License Number State | VA
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