Provider Demographics
NPI:1558976878
Name:MELTON, ANGELA WADE
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:WADE
Last Name:MELTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 KLUMAC RD STE 7
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-6752
Mailing Address - Country:US
Mailing Address - Phone:704-223-0345
Mailing Address - Fax:
Practice Address - Street 1:512 KLUMAC RD STE 7
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-6752
Practice Address - Country:US
Practice Address - Phone:704-223-0345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC911237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist