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NPI Code Detail

MEDICARE: MRS. MELISSA WALLING MORRISON MCD-CCC, SLP

MEDICARE: MRS. MELISSA WALLING MORRISON MCD-CCC, SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSP# 1079AR

General Provider Information

NPI Number : 1194974105
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELISSA WALLING MORRISON MCD-CCC, SLP
Provider Business Mailing Address
First Line : PO BOX 1008
Second Line :
City : MELBOURNE
State : AR
Zip : 72556-1008
Country : US
Telephone Number : 870-368-5608
Fax Number :
Provider Business Practice Location Address
First Line : 711 N MAIN ST
Second Line :
City : CAVE CITY
State : AR
Zip : 72521-9103
Country : US
Telephone Number : 870-283-3303
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2008
Last Update Date : 09/15/2008

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Directions to “ MRS. MELISSA WALLING MORRISON MCD-CCC, SLP” Practice Location

Language Start Address Practice Location
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