MEDICARE: MELISSA HYING M.S. 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
1	235Z00000X	Speech-Language Pathologist	4195-154	WI

General Provider Information

NPI Number	:	1407226301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA HYING M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	10849 W DERBY AVE
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53225-4558
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8707 W NORTH AVE
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-2723
Country	:	US
Telephone Number	:	414-208-0753
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2015
Last Update Date	:	03/14/2019

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