Provider Demographics
NPI:1053778100
Name:SANCRANT, MELISSA ANN (MED CCC-SLP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:SANCRANT
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5240 POETS WAY
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-5927
Mailing Address - Country:US
Mailing Address - Phone:330-416-0612
Mailing Address - Fax:
Practice Address - Street 1:1302 MILLVILLE AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-3961
Practice Address - Country:US
Practice Address - Phone:513-867-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-5889235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist