Provider Demographics
NPI:1598989634
Name:SINGLETON, MELANIE (SP)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5613 WOODCREEK DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-3114
Mailing Address - Country:US
Mailing Address - Phone:937-479-5581
Mailing Address - Fax:
Practice Address - Street 1:5613 WOODCREEK DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-3114
Practice Address - Country:US
Practice Address - Phone:937-479-5581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 8457235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0510772Medicaid
OH000000551897OtherANTHEM GROUP #
OH0510772Medicaid