Individual
MELISSA ANNE MIMIDIS HORWATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
8270 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4530
(571) 423-4900
Mailing address
450 W BROAD ST, SUITE 215, FALLS CHURCH, VA 22046-3340
(703) 533-8819
(703) 533-7723
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005366
VA
235Z00000X
Speech-Language Pathologist
50-1216113
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
231365369
TAX IDENTIFICATION NUMBER
PA
Enumeration date
04/10/2006
Last updated
08/17/2024
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