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General NPI Number Information
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NPI Number | 1568376002
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Entity Type | Individual
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Provider Name | MELISSA NOLAN
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Gender | Female
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 690 N LAKE PLEASANT RD
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City | ATTICA
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State | MI
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Zip | 48412-9770
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Country | US
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Telephone | 810-338-1875
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Fax |
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Provider Business Mailing Address
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Address Line | 5457 THOMAS RD
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City | METAMORA
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State | MI
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Zip | 48455-9289
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Country | US
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Telephone | 810-338-1875
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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 | 14112337
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License Number State | MI
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