Provider Demographics
NPI:1417184847
Name:MORI, MELANIE RISA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:RISA
Last Name:MORI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 HARDING AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-2412
Mailing Address - Country:US
Mailing Address - Phone:808-735-6981
Mailing Address - Fax:
Practice Address - Street 1:3515 HARDING AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2412
Practice Address - Country:US
Practice Address - Phone:808-735-6981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HISP-589235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist