Individual
MELANIE BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
433 RIDGEWOOD ST, VICKSBURG, MS 39180-5443
(601) 883-9847
Mailing address
433 RIDGEWOOD ST, VICKSBURG, MS 39180-5443
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S2934
MS
Other
Enumeration date
02/19/2010
Last updated
02/19/2010
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