Provider Demographics
NPI:1467641845
Name:LEE, MELODY WARD (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:WARD
Last Name:LEE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:MELODY
Other - Middle Name:WARD
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1321 MCMILLAN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BREWTON
Mailing Address - State:AL
Mailing Address - Zip Code:36426-1324
Mailing Address - Country:US
Mailing Address - Phone:251-809-2500
Mailing Address - Fax:251-867-7151
Practice Address - Street 1:1321 MCMILLAN AVE STE A
Practice Address - Street 2:
Practice Address - City:BREWTON
Practice Address - State:AL
Practice Address - Zip Code:36426-1324
Practice Address - Country:US
Practice Address - Phone:251-809-2500
Practice Address - Fax:251-867-7151
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2430235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist