Provider Demographics
NPI:1316001522
Name:NORRIS, MELISSA ELLEN (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ELLEN
Last Name:NORRIS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 CHARING CROSS CIR
Mailing Address - Street 2:
Mailing Address - City:MABELVALE
Mailing Address - State:AR
Mailing Address - Zip Code:72103-8786
Mailing Address - Country:US
Mailing Address - Phone:501-602-2396
Mailing Address - Fax:
Practice Address - Street 1:21801 ARCH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72206-9233
Practice Address - Country:US
Practice Address - Phone:501-888-4264
Practice Address - Fax:501-888-4275
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#1317235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist