Provider Demographics
NPI:1437454725
Name:THOMPSON, MELODEE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELODEE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:MELODEE
Other - Middle Name:
Other - Last Name:HAMMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:14659 CRESCENT MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49319-8937
Mailing Address - Country:US
Mailing Address - Phone:614-390-6130
Mailing Address - Fax:
Practice Address - Street 1:14659 CRESCENT MEADOWS DR
Practice Address - Street 2:
Practice Address - City:CEDAR SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49319-8937
Practice Address - Country:US
Practice Address - Phone:614-390-6130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-9087235Z00000X
MI235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist