Provider Demographics
NPI:1215206974
Name:MCLAUGHLIN, MELINDA N (SLP)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:N
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 S GILLETTE AVE
Mailing Address - Street 2:
Mailing Address - City:BAYPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11705-2239
Mailing Address - Country:US
Mailing Address - Phone:631-472-9428
Mailing Address - Fax:
Practice Address - Street 1:241 S OCEAN AVE
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-3732
Practice Address - Country:US
Practice Address - Phone:631-687-6340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010347235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist