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NPI 1619947603

NPI 1619947603 : MELISSA L. MORGAN CCC : BOSTON, MA

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General NPI Number Information
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    NPI Number           |    1619947603
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    Entity Type          |    Individual 
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    Provider Name        |    MELISSA L. MORGAN CCC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/24/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    133 BROOKLINE AVE 
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    City                 |    BOSTON
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    State                |    MA
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    Zip                  |    02215-3904
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    Country              |    US
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    Telephone            |    617-421-5984
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    147 MILK ST PROVIDER ENROLLMENT - 9TH FLOOR
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    City                 |    BOSTON
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    State                |    MA
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    Zip                  |    02109-4806
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    Country              |    US
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    Telephone            |    617-559-8051
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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        |    231H00000X
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    Taxonomy Name        |    Audiologist
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    License Number       |    755
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    License Number State |    MA
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