Provider Demographics
NPI:1609386366
Name:MEIER, MELINDA SUE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:SUE
Last Name:MEIER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22865 COUNTY ROAD 78
Mailing Address - Street 2:
Mailing Address - City:PEETZ
Mailing Address - State:CO
Mailing Address - Zip Code:80747-9625
Mailing Address - Country:US
Mailing Address - Phone:970-520-4622
Mailing Address - Fax:
Practice Address - Street 1:134 PARK CENTRAL SQ STE 220
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65806-1356
Practice Address - Country:US
Practice Address - Phone:844-536-8266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20107030880235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist