Provider Demographics
NPI:1336178946
Name:ANDERSON, MELISSA L (AUD)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:L
Last Name:ANDERSON
Suffix:
Gender:
Credentials:AUD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:L
Other - Last Name:ANDERSON-POLLINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:8617 FIFTEEN MILE RD.
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312
Mailing Address - Country:US
Mailing Address - Phone:586-558-7477
Mailing Address - Fax:586-558-7479
Practice Address - Street 1:8617 FIFTEEN MILE RD.
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312
Practice Address - Country:US
Practice Address - Phone:586-558-7477
Practice Address - Fax:586-558-7479
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000050231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist