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NPI 1972051233

NPI 1972051233 : MELISSA MALONEY SLP : VICTOR, NY

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General NPI Number Information
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    NPI Number           |    1972051233
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    Entity Type          |    Individual 
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    Provider Name        |    MELISSA MALONEY SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/15/2016
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    Last Update Date     |    09/15/2016
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Provider Practice Location Address
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    Address Line         |    590 FISHERS STATION DR STE 130 
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    City                 |    VICTOR
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    State                |    NY
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    Zip                  |    14564-9744
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    Country              |    US
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    Telephone            |    585-924-7207
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6681 SAINT JOHNS PKWY 
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    City                 |    VICTOR
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    State                |    NY
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    Zip                  |    14564-9256
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    Country              |    US
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    Telephone            |    585-398-7212
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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       |    007533-1
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    License Number State |    NY
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