Provider Demographics
NPI:1518697168
Name:MCCLAIN, MELANIE KAY (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:KAY
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:KAY
Other - Last Name:HEGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:1640 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-1518
Mailing Address - Country:US
Mailing Address - Phone:316-516-4674
Mailing Address - Fax:
Practice Address - Street 1:1640 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-1518
Practice Address - Country:US
Practice Address - Phone:316-516-4674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS542235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist