Provider Demographics
NPI:1447664610
Name:DIPASQUALE, MELISSA (MAT, MS, CCC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:DIPASQUALE
Suffix:
Gender:F
Credentials:MAT, MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2734
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93902-2734
Mailing Address - Country:US
Mailing Address - Phone:831-521-9686
Mailing Address - Fax:
Practice Address - Street 1:106 CASENTINI ST APT C
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93907-2212
Practice Address - Country:US
Practice Address - Phone:831-521-9686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 20699235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist