Provider Demographics
NPI:1497922207
Name:PROUSE, MELODY DANIELLE (AUD)
Entity Type:Individual
Prefix:DR
First Name:MELODY
Middle Name:DANIELLE
Last Name:PROUSE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 SAINT CHRISTOPHER DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7087
Mailing Address - Country:US
Mailing Address - Phone:606-836-3681
Mailing Address - Fax:606-834-8518
Practice Address - Street 1:1101 SAINT CHRISTOPHER DR
Practice Address - Street 2:SUITE 350
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7087
Practice Address - Country:US
Practice Address - Phone:606-836-3681
Practice Address - Fax:606-834-8518
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0481231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist