Provider Demographics
NPI:1437286697
Name:TROCKI, MELINDA DIANNE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:DIANNE
Last Name:TROCKI
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201STATE ST.
Mailing Address - Street 2:SPEECH DEPARTMENT
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16550-0002
Mailing Address - Country:US
Mailing Address - Phone:814-877-6214
Mailing Address - Fax:
Practice Address - Street 1:201 STATE ST
Practice Address - Street 2:SPEECH DEPARTMENT
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16550-0002
Practice Address - Country:US
Practice Address - Phone:814-877-6214
Practice Address - Fax:814-877-2653
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL004824L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist