Provider Demographics
NPI:1306152608
Name:GILLILAND, MELISSA S (MS, SLP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:S
Last Name:GILLILAND
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 BUELL RD
Mailing Address - Street 2:
Mailing Address - City:CURWENSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16833-7427
Mailing Address - Country:US
Mailing Address - Phone:814-577-7716
Mailing Address - Fax:
Practice Address - Street 1:552 BUELL RD
Practice Address - Street 2:
Practice Address - City:CURWENSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16833-7427
Practice Address - Country:US
Practice Address - Phone:814-577-7716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist