Individual
MELISSA PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
806 S KINGSHIGHWAY ST, SIKESTON, MO 63801-5919
(573) 471-0110
(573) 472-1880
Mailing address
806 S KINGSHIGHWAY ST, SIKESTON, MO 63801-5919
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2009022126
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA1733009
MEDICARE PTAN
MO
Enumeration date
02/21/2012
Last updated
06/02/2014
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