Individual
MRS. MELISSA MOORE FASTIGGI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1605 CALIBRE WOODS DR NE, ATLANTA, GA 30329-3954
(706) 340-1704
Mailing address
1605 CALIBRE WOODS DR NE, ATLANTA, GA 30329-3954
(706) 340-1704
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006337
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
323213827A
—
GA
Enumeration date
10/02/2006
Last updated
03/24/2016
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