Individual
MELISSA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4239 VIENNA WAY, MARIETTA, GA 30062
(770) 355-3087
(770) 200-1541
Mailing address
4239 VIENNA WAY, MARIETTA, GA 30062-5721
(770) 355-3087
(770) 200-1541
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005625
GA
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137912733G
—
GA
Enumeration date
11/22/2006
Last updated
07/10/2018
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