Provider Demographics
NPI:1992978266
Name:COLLINS, MELISSA M (AUD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:COLLINS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:M
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1215 DUFF AVE
Mailing Address - Street 2:PO BOX 3014
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-5400
Mailing Address - Country:US
Mailing Address - Phone:515-239-4421
Mailing Address - Fax:515-239-4539
Practice Address - Street 1:1215 DUFF AVE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-5400
Practice Address - Country:US
Practice Address - Phone:515-239-4421
Practice Address - Fax:515-239-4539
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00783231H00000X
IA00518231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA00783OtherLICENSE