Provider Demographics
NPI:1194242974
Name:BISHOP, MELANIE ELYSE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:ELYSE
Last Name:BISHOP
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TRAFALGAR SQ STE 204
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-1998
Mailing Address - Country:US
Mailing Address - Phone:603-577-5517
Mailing Address - Fax:
Practice Address - Street 1:1 TRAFALGAR SQUARE
Practice Address - Street 2:SUITE 204
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063
Practice Address - Country:US
Practice Address - Phone:603-577-5517
Practice Address - Fax:603-521-7434
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1745235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist