Provider Demographics
NPI:1992855522
Name:VOSE, MELISSA ANN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:VOSE
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 1:612 S LESLIE ST
Mailing Address - Street 2:
Mailing Address - City:STUTTGART
Mailing Address - State:AR
Mailing Address - Zip Code:72160-4840
Mailing Address - Country:US
Mailing Address - Phone:870-672-3443
Mailing Address - Fax:870-747-9970
Practice Address - Street 1:612 S LESLIE ST
Practice Address - Street 2:
Practice Address - City:STUTTGART
Practice Address - State:AR
Practice Address - Zip Code:72160-4840
Practice Address - Country:US
Practice Address - Phone:870-672-3443
Practice Address - Fax:870-747-9970
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1551235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist