Provider Demographics
NPI:1972280477
Name:MUSSELMAN, MELANIE
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:MUSSELMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4102 SKYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17329-9220
Mailing Address - Country:US
Mailing Address - Phone:717-634-7617
Mailing Address - Fax:
Practice Address - Street 1:4102 SKYVIEW DR
Practice Address - Street 2:
Practice Address - City:GLENVILLE
Practice Address - State:PA
Practice Address - Zip Code:17329-9220
Practice Address - Country:US
Practice Address - Phone:717-634-7617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-28
Last Update Date:2025-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL01426235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist