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General NPI Number Information
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NPI Number | 1588170567
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Entity Type | Individual
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Provider Name | MELISSA JOAN BARTLETT
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Gender | Female
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Dates
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Enumeration Date | 12/28/2017
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 428 STORY ST
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City | BOONE
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State | IA
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Zip | 50036
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Country | US
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Telephone | 515-432-3277
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Fax | 515-432-3277
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Provider Business Mailing Address
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Address Line | 428 STORY ST
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City | BOONE
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State | IA
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Zip | 50036-3532
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Country | US
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Telephone | 515-432-3277
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Fax | 515-432-3277
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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 | 231HA2400X
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Taxonomy Name | Assistive Technology Practitioner Audiologist
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License Number | 074715
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License Number State | IA
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