Provider Demographics
NPI:1083195572
Name:SMITH, MELODY BROWN (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:BROWN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:MS
Other - First Name:MELODY
Other - Middle Name:LEIGHANN
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3034 SHERBORNE ST
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3354
Mailing Address - Country:US
Mailing Address - Phone:601-938-3267
Mailing Address - Fax:
Practice Address - Street 1:9330 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7891
Practice Address - Country:US
Practice Address - Phone:832-856-6241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty