Individual ProviderMelissa M Bradley-PotterSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address13336 Industrial Rd, Suite 105, Omaha, NE 68137-1124(402) 330-3211PECOS EnrollmentBased on the most recent information from CMS, provider Melissa M Bradley-Potter does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 38 days ago.Profile DetailsProvider ID1891753695Provider TypeIndividualFull NameBradley-Potter, Melissa MCredentialCFY/SLPGenderFemaleSole ProprietorNoEnumeration Date5/2/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address13336 Industrial Rd, Suite 105, Omaha, NE 68137-1124Phone(402) 330-3211Fax(402) 330-5970Mailing LocationMailing Address13336 Industrial Rd, Suite 105, Omaha, NE 68137-1124Phone(402) 330-3211Fax(402) 330-5970Provider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense120NebraskaProvider IdentifiersIDDescriptionIssuerID47065477700DescriptionMedicaidIssuerUnlistedNebraska