Provider Demographics
NPI:1568634988
Name:BROWN-SPENCE, MELISSA R (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:R
Last Name:BROWN-SPENCE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 W BAILEY AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-1222
Mailing Address - Country:US
Mailing Address - Phone:479-530-8181
Mailing Address - Fax:
Practice Address - Street 1:3511 SILENT GROVE RD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-7913
Practice Address - Country:US
Practice Address - Phone:479-530-8181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#P7909235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist