Individual
MRS. MELISSA ANNE MILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCCC/SLP
Contact information
Practice address
103 N 12TH AVE, HOPEWELL, VA 23860-2310
(609) 410-4725
Mailing address
4102 BRIGHTWAY DR, HENRICO, VA 23294-5569
(609) 410-4725
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202008963
VA
235Z00000X
Speech-Language Pathologist
41YS00307500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356644827
TYPE 2
NJ
01
—
196764
PTAN
NJ
Enumeration date
06/07/2006
Last updated
07/07/2022
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