Individual
MELISSA MYERS COUSINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
3 BENTRIDGE RD, FALMOUTH, FALMOUTH, ME 04105-2539
(207) 590-0625
Mailing address
3 BENTRIDGE RD, FALMOUTH, FALMOUTH, ME 04105-2539
(207) 590-0625
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
249
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
METPID001398
—
ME
Enumeration date
03/25/2007
Last updated
03/19/2011
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