Melissa Lynn Mortenson | Jacksonville Beach, FL • PECOS Search

Melissa Lynn Mortenson

Speech-Language Pathologist

Speech, Language and Hearing Service Providers

333 1st St N, Suite 200, Jacksonville Beach, FL 32250-6945

PECOS Enrollment

Based on the most recent information from CMS, provider Melissa Lynn Mortenson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1063655819
Provider Type
Individual
Full Name
Mortenson, Melissa Lynn
Credential
MS, CCC-SLP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
4/9/2009
Last Updated
4/9/2009

Contact Information

Practice Location

333 1st St N, Suite 200, Jacksonville Beach, FL 32250-6945

Unlisted Fax

Mailing Location

16 Andrew Lane, Box 1295, Pinedale, WY 82941-1295

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 235Z00000X Primary	Description Speech-Language Pathologist Speech, Language and Hearing Service Providers	License 004113 Connecticut