MEDICARE: MELISSA BENDIXSEN

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	34407	CA
2	235Z00000X	Speech-Language Pathologist	TSLP-2634	ID
3	235Z00000X	Speech-Language Pathologist	SLP101623	MA
4	235Z00000X	Speech-Language Pathologist	SLP-2808	ID

General Provider Information

NPI Number	:	1639579097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA BENDIXSEN

Provider Business Mailing Address
First Line	:	465 UNDERWOOD ST
Second Line	:
City	:	HOLLISTON
State	:	MA
Zip	:	01746-1510
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	465 UNDERWOOD ST
Second Line	:
City	:	HOLLISTON
State	:	MA
Zip	:	01746-1510
Country	:	US
Telephone Number	:	774-527-9612
Fax Number	:

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

Provider Enumeration Date	:	09/03/2014
Last Update Date	:	05/24/2026

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Directions to “ MELISSA BENDIXSEN ” Practice Location

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