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NPI Code Detail

MEDICARE: MELISSA G HERZIG M.S.CCC

MEDICARE: MELISSA G HERZIG M.S.CCC
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 Pathologist912MN

General Provider Information

NPI Number : 1548477862
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA G HERZIG M.S.CCC
Provider Business Mailing Address
First Line : 17630 JUNIPER PATH STE A
Second Line :
City : LAKEVILLE
State : MN
Zip : 55044-5754
Country : US
Telephone Number : 952-232-2000
Fax Number :
Provider Business Practice Location Address
First Line : 17630 JUNIPER PATH STE A
Second Line :
City : LAKEVILLE
State : MN
Zip : 55044-5754
Country : US
Telephone Number : 952-232-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2007
Last Update Date : 05/19/2026

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