Provider Demographics
NPI:1154808202
Name:CAREY, MELISSA WARDE (SLP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:WARDE
Last Name:CAREY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1691 PERCY
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48357-3428
Mailing Address - Country:US
Mailing Address - Phone:734-417-2572
Mailing Address - Fax:
Practice Address - Street 1:1691 PERCY
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:MI
Practice Address - Zip Code:48357-3428
Practice Address - Country:US
Practice Address - Phone:734-417-2572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-22
Last Update Date:2018-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101000300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty