Provider Demographics
NPI:1033653324
Name:PHIFER, MELANIE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:PHIFER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1038 N 2525 W
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-7710
Mailing Address - Country:US
Mailing Address - Phone:801-540-1739
Mailing Address - Fax:
Practice Address - Street 1:1133 N MAIN ST
Practice Address - Street 2:#206
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-4800
Practice Address - Country:US
Practice Address - Phone:801-689-7459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8809985-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist