Provider Demographics
NPI:1487752556
Name:GIVENS, MELISSA BETH (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:BETH
Last Name:GIVENS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 LAS VEGAS DR
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-5333
Mailing Address - Country:US
Mailing Address - Phone:270-887-0947
Mailing Address - Fax:270-887-0947
Practice Address - Street 1:609 LAS VEGAS DR
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-5333
Practice Address - Country:US
Practice Address - Phone:270-887-0947
Practice Address - Fax:270-887-0947
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2264235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist