Provider Demographics
NPI:1003577065
Name:MELENDREZ, VICTORIA EILEEN (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:EILEEN
Last Name:MELENDREZ
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 BELL TOWER HTS APT 307
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80916-1952
Mailing Address - Country:US
Mailing Address - Phone:509-834-0429
Mailing Address - Fax:
Practice Address - Street 1:1710 JET STREAM DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3937
Practice Address - Country:US
Practice Address - Phone:719-434-1109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSLP.0000902235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist